By reformatting these transverse images or taking coronal images, the examination of orbital floor and roof is permitted. Helical scanning is preferred as it has a lower imaging time and radiation dose comparing to conventional scanning, especially when reforming transverse helical scans into coronal images. The staging of orbital emphysema can then be determined with visual acuity examination and ophthalmoscopy. A disadvantage of using a CT scan is that when detecting air after orbital trauma, the presence of a wooden foreign object can give a false positive result of orbital emphysema. The wooden object can mimic the presence of orbital emphysema. Therefore, patients’ medical history is crucial in making the correct diagnosis. Other tests
Conventional radiography is commonly employed for imaging orbital injuries and identifying orbital fractures. It can be used to diagnose orbital emphysema because it shows the presence of air in the orbit best while the patient is standing upright. Skull films of posterior-anterior, lateral projections, and orbital rim views are recommended to show fractures in orbital rims and walls. However, CT scan is better than conventional radiography in the diagnosis of the condition, as it has a lower high false-negative rate and non-diagnostic rate.Orbital emphysema can also be diagnosed by magnetic resonance imaging (MRI). Although MRI has a low sensitivity for detecting orbital fractures, it can be used to evaluate rectus muscle pathology, optic nerve pathology, and brain pathology, as well as vascular injury. Treatment
Orbital emphysema on its own is a mild and self-limiting disease.
Acatalasia  is an autosomal recessive peroxisomal disorder caused by absent or very low levels of the enzyme catalase. Catalase breaks down hydrogen peroxide in cells into water and oxygen. Low levels of catalase can cause hydrogen peroxide to build up, causing damage to cells. Presentation
The disorder is relatively benign, although it causes an increased incidence of oral ulcers, and can under rare circumstances lead to gangrene. Symptoms primarily affect children. Genetic
Acatalasia is often the result of mutations in both copies of the CAT gene which codes for the enzyme catalase. There are multiple types of mutation that can cause this condition. Inheriting a single CAT mutation results in hypocatalasia, in which catalase levels are reduced, but still at functional levels. Diagnosis
This disorder is commonly diagnosed pouring hydrogen peroxide on the patients blood sample. Instead of a very bubbling reaction, blood turns brown-colored, which means the patient suffers from acatalasia. Management
Epidemiology
In parts of Japan, this condition has been found in approximately 1.4% of people. Researchers estimate that the condition occurs in 1 in 20,000 people in Hungary and Switzerland. History
In 1948, Dr. Shigeo Takahara (1908–1994), a Japanese otolaryngologist first reported this new disease. He had examined a patient with an oral ulcer. He had spread hydrogen peroxide on the diseased part, but oxygen was not generated due to the lack of catalase. See also
List of cutaneous conditions

References


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