Sub‐Tenon Emphysema From Compressed Air Injury in a Patient With Marfan Syndrome

Compressed air injuries to the globe are rare and typically associated with orbital fractures or a visible entry wound. The authors report the case of a 16‐year‐old male with Marfan syndrome who developed orbital emphysema strictly confined to the sub‐Tenon′s space following a compressed air injury, without any visible entry wound or orbital fracture. Clinical examination demonstrated a well‐demarcated subconjunctival air pocket located approximately 3–4 mm posterior to the limbus, consistent with the anterior insertion of Tenon′s capsule. Computed tomography confirmed a localized intraorbital air without evidence of fracture or sinus communication. A plausible mechanism is that high‐pressure air entered through microscopic tissue disruption and dissected along Tenon′s capsule into the sub‐Tenon space. The patient was managed conservatively with spontaneous resolution. This case provides a well‐documented example of localized sub‐Tenon emphysema and illustrates the anatomical boundaries of the sub‐Tenon space in vivo.