Abstract Listings 2024

Purpose

Introduction:
Pneumatic orbital injury, a rare but serious trauma, occurs when pressurized air forcibly enters the orbital tissues, typically from industrial accidents involving pneumatic tools. These injuries can cause subcutaneous and orbital emphysema, exophthalmos and ocular damage. They can also cause orbital bone disorders, intracranial injuries and affect other systems. Prompt diagnosis and appropriate treatment are crucial to prevent complications and preserve vision. This case report examines a 46-year-old male with such an injury.

Methods

Case Presentation:
A 46-year-old male presented to the ophthalmology emergency department one hour after a pneumatic pump accident. The accident occurred when he accidentally directed a pneumatic gun, with a pressure of approximately 8 bars, towards the right side of his head while cleaning his clothes. The patient reported a headache, inability to open his right eye, and a sensation of pressure in the periocular region, while clinical examination revealed crepitus in the periocular area, indicating subcutaneous emphysema with preseptal cellulitis. Slit lamp examination showed numerous sub-conjunctival bubbles without conjunctival laceration or ocular trauma, except for conjunctival hemorrhage. Visual acuity and color vision were preserved, intraocular pressure was within normal range and posterior segment examination was unremarkable. Computed tomography (CT) revealed right temporal, periorbital, paramaxillary, and paranasal emphysema, along with intraorbital retrobulbar emphysema and exophthalmos. The globe was intact, and no acute bone fractures were identified. Mourits exophthalmometry indicated a 6 mm exophthalmos.
The patient received local antiglaucomatous, corticosteroid, and antibiotic therapy, along with systemic antibiotics and rest recommendations. After 24 hours periocular pressure was reduced eventhough exophthalmos persisted. The patient maintained visual acuity, with no signs of necrotizing fasciitis or traumatic optic neuropathy.

Results

Case Presentation:
A 46-year-old male presented to the ophthalmology emergency department one hour after a pneumatic pump accident. The accident occurred when he accidentally directed a pneumatic gun, with a pressure of approximately 8 bars, towards the right side of his head while cleaning his clothes. The patient reported a headache, inability to open his right eye, and a sensation of pressure in the periocular region, while clinical examination revealed crepitus in the periocular area, indicating subcutaneous emphysema with preseptal cellulitis. Slit lamp examination showed numerous sub-conjunctival bubbles without conjunctival laceration or ocular trauma, except for conjunctival hemorrhage. Visual acuity and color vision were preserved, intraocular pressure was within normal range and posterior segment examination was unremarkable. Computed tomography (CT) revealed right temporal, periorbital, paramaxillary, and paranasal emphysema, along with intraorbital retrobulbar emphysema and exophthalmos. The globe was intact, and no acute bone fractures were identified. Mourits exophthalmometry indicated a 6 mm exophthalmos.
The patient received local antiglaucomatous, corticosteroid, and antibiotic therapy, along with systemic antibiotics and rest recommendations. After 24 hours periocular pressure was reduced eventhough exophthalmos persisted. The patient maintained visual acuity, with no signs of necrotizing fasciitis or traumatic optic neuropathy.

Conclusion

Conclusion:
This case highlights the importance of prompt and thorough evaluation in cases of orbital trauma caused by high-pressure pneumatic devices. Comprehensive management, including imaging and multidisciplinary care, is crucial for preventing complications and ensuring optimal recovery.

Additional Authors

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