title: Orbital emphysema and diplopia following thoracotomy.
abstract: OBJECTIVE
  To describe the clinical and radiological findings in a patient with diplopia and orbital emphysema following thoracotomy.
  
  
  METHODS
  Reported is a 71-year-old woman who presented with diplopia several days following thoracotomy.
  
  
  RESULTS
  Physical examination revealed diffuse subcutaneous emphysema and a right hypertropia. Head computed tomography revealed facial and palpebral subcutaneous emphysema extending into the infratemporal fossa and orbits bilaterally. A chest tube was replaced and her diplopia resolved.
  
  
  CONCLUSIONS
  Subcutaneous emphysema can lead to diplopia and orbital emphysema in the absence of orbital trauma. Contrary to previously suggested mechanisms of orbital emphysema associated with subcutaneous emphysema, computed tomography imaging suggested that air entry into the orbit in this case was through the inferior orbital fissure.
authors.affiliation: Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, USA.
authors.forename: R J
authors.initials: RJ
authors.lastname: Fox
authors.forename: J W
authors.initials: JW
authors.lastname: Teener
authors.forename: G T
authors.initials: GT
authors.lastname: Liu
mesh_terms: D000368:Aged; D004172:Diplopia / Q000209:etiology*; D004646:Emphysema / Q000209:etiology*; D005260:Female; D006801:Humans; D009916:Orbital Diseases / Q000209:etiology* / Q000473:pathology; D013908:Thoracotomy / Q000009:adverse effects*; D014054:Tomography