title: Orbital fracture due to high-pressure air injection.
abstract: We present a case of orbital fracture associated with emphysema and pneumocephalus caused by a high-pressured air injection in the eyeball. A 49-year-old man injured his right eye while working with a high-pressure (compressed) air jet in a workshop. The periorbital area was swollen and ecchymotic. The bulbar conjunctiva sustained multiple lacerations around the pupil: 9 mm at 12 o'clock in direction, 6 mm at 3, 8 mm at 6, and 6 mm at 9, respectively. Computed tomography showed crisp emphysema around the right orbit, and a fracture of the medial wall of the orbit. Free air was also seen near the basal cistern and sylvian fissure, indicating a pneumocephalus. Our case proved a high pneumatic pressure could induce a fracture of the medial wall of the orbit. Green et al (Ophthal Plast Reconstr Surg 1990;6:211-217) suggested that a consistent force of more than 2.08 J is enough to inflict injury on the orbital wall.
authors.affiliation: Departments of Plastic Surgery, and Center for Advanced Medical Education by BK21 Project, Inha University School of Medicine, Incheon, Korea.
authors.forename: Kun
authors.initials: K
authors.lastname: Hwang
authors.forename: Dong Hyun
authors.initials: DH
authors.lastname: Kim
authors.forename: Hong Sik
authors.initials: HS
authors.lastname: Lee
mesh_terms: D000062:Accidents, Occupational; D058868:Compressed Air / Q000009:adverse effects*; D003228:Conjunctiva / Q000293:injuries; D004438:Ecchymosis / Q000209:etiology; D004646:Emphysema / Q000209:etiology; D005131:Eye Injuries / Q000209:etiology; D006801:Humans; D022125:Lacerations / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009916:Orbital Diseases / Q000209:etiology; D009917:Orbital Fractures / Q000209:etiology*; D011007:Pneumocephalus / Q000209:etiology; D014057:Tomography, X-Ray Computed