The Bubble Eye Sign: Understanding the Radiological Imaging of Gas inside the Orbit
Gas, appears as radiolucent on X-ray, is normally absent in the orbit. However, intraocular surgeries occasionally utilize retained intraocular gas for tamponade effect. Intravitreal gas persists after retinal surgery, being confounded by the scleral shell of the operated eye, outlines the shape of the eyeball, and gives the characteristic bubble appearance on skull X-ray. This is different from orbital emphysema caused by orbital fracture when gas is located outside the globe but confined by the orbit, giving a crescent or concave shape over the superior orbit usually. Falls is common after intraocular retinal surgeries due to change of usual stereopsis, prolonged prone posturing, and other systemic comorbidities. By identifying the “Bubble Eye sign” described, attending physician should alert the presence of intravitreal gas, most commonly iatrogenic. Further ophthalmological history taking and examinations are thus indicated, instead of exposing patients to unnecessary radiation under computed tomography scan for orbital fracture investigation.
27. Juli 2021 (online)
© 2021. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India
- 1 Vaziri K, Schwartz SG, Kishor KS, Flynn Jr HW. Tamponade in the surgical management of retinal detachment. Clin Ophthalmol 2016; 10: 471-476
- 2 Singh NP, Said DG, Dua HS. Lamellar keratoplasty techniques. Indian J Ophthalmol 2018; 66 (09) 1239-1250
- 3 Kontos A, Tee J, Stuart A, Shalchi Z, Williamson TH. Duration of intraocular gases following vitreoretinal surgery. Graefes Arch Clin Exp Ophthalmol 2017; 255 (02) 231-236
- 4 Ooshiro T, Iijima H. Postoperative recovery of light sensitivity in eyes with rhegmatogenous retinal detachment. Ophthalmologica 2017; 238 (01/02) 52-58
- 5 Dionyssiotis Y. Analyzing the problem of falls among older people. Int J Gen Med 2012; 5: 805-813