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Three-Dimensional Reconstruction of Orbital Fractures

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Diplopia due to mask barotrauma.

Emi Latham¹, Karen van Hoesen, Ian Grover

¹Department of Emergency Medicine, Division of Hyperbaric Medicine, University of California, San Diego, San Diego, California 92103-8676, USA.

The Journal of Emergency Medicine

|November 11, 2008

Summary

Scuba diving injuries like barotrauma or arterial gas embolism require careful history and physical exams. Differentiating these conditions is crucial for proper treatment, as shown in a case where mask barotrauma caused diplopia.

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Area of Science:

Diving medicine
Emergency medicine
Neurology

Background:

Scuba diving is a popular sport with occasional risks including barotrauma, decompression sickness, and arterial gas embolism.
Accurate diagnosis of diving-related injuries is essential for appropriate treatment.
History and physical examination are critical first steps in evaluating injured divers.

Observation:

A scuba diver presented with symptoms initially suspected to be an arterial gas embolism.
Detailed patient history and a thorough physical examination were conducted.
The diver experienced diplopia (double vision).

Findings:

The patient's diplopia was determined to be caused by barotrauma from their diving mask, not an arterial gas embolism.
An orbital computed tomography (CT) scan confirmed an orbital hematoma, explaining the proptosis and double vision.
The isolated neurological sign of diplopia was inconsistent with arterial gas embolism.

Implications:

Careful clinical evaluation can differentiate between various scuba diving injuries.
Prompt and accurate diagnosis based on history and physical exam guides appropriate treatment protocols.
Understanding the specific etiology of symptoms is vital for diver safety and recovery.