Sight-threatening orbital emphysema treated with needle decompression.

Orbital emphysema is rare in the absence of trauma, and is unlikely to result in visual loss. The authors describe a patient with no prior trauma who presented with decreased vision and increased intraocular pressure due to severe orbital emphysema after a sneeze. Computed tomography revealed subcutaneous emphysema of the lid and extraconal air in the orbit. Emergency needle decompression resulted in improvement in vision and intraocular pressure.