Supplementary Material for: 20/20 to NLP Due to Blowing the Nose and Orbital Emphysema: A Case Report

Introduction
Orbital emphysema is characterized by presence of air in the soft tissues of the orbits. In severe cases this can lead to orbital compartment syndrome, a medical emergency that can result in severe permanent vision loss without urgent intervention. Generally, the severity of presenting vision loss and longer time to intervention have been associated with worse visual outcome.

Case presentation
We present the case of a 26-year-old healthy male who developed an acute orbital compartment syndrome with orbital emphysema following nose blowing in the setting of a bacterial orbital cellulitis. Once documented to have no light perception (NLP) vision in the affected eye, he was urgently taken to the operating room for surgical decompression (approximately 2.5 hours after onset of the NLP). Over the subsequent days, he gradually regained 20/20 visual acuity.

Conclusion
This case highlights that despite complete loss of vision, this patient had an excellent visual outcome.

引言
眼眶气肿（Orbital emphysema）以眼眶软组织内存在气体为主要特征。重症病例可引发眼眶筋膜室综合征，该病症属于医疗急症，若未实施紧急干预，可导致永久性严重视力丧失。通常来说，就诊时的视力丧失程度与干预延迟时长均与较差的视觉预后相关。

病例报告
本文报告1例26岁健康男性患者，其在细菌性眼眶蜂窝织炎的背景下，因擤鼻诱发急性眼眶筋膜室综合征合并眼眶气肿。患眼确诊无光感知（NLP）视力后，患者于无光感知症状出现约2.5小时后被紧急送入手术室接受手术减压治疗。在后续数日中，患者的视力逐步恢复至20/20。

结论
本病例表明，即便发生完全性视力丧失，该患者仍可获得极佳的视觉预后。