Orbital emphysema after probing for congenital nasolacrimal duct obstruction.

A 22-month-old boy with bilateral epiphora since birth and positive fluorescein dye disappearance test in both eyes underwent nasolacrimal duct probing, with multiple passes to ensure that the obstruction was resolved. Immediately after the procedure was completed, bilateral orbital emphysema developed. The patient was started on systemic antibiotics and systemic steroids and monitored closely. Fundus examination revealed no abnormalities. The emphysema began to resolve on postoperative day 2 and had resolved completely by postoperative day 10.