A 28-year-old male patient presented to the emergency department with a sudden onset of unilateral orbital swelling associated with pain immediately after he had an episode of forceful sneezing. There was no history of trauma. Physical examination revealed obvious right orbital swelling. The patient had difficulty opening the right eye
however, the eye movements were within normal limits. Visual acuity was intact. In the absence of trauma, orbital cellulitis was considered as the differential diagnosis. However, computed tomography (CT) of the orbit showed a fracture of the medial wall of the right orbit with air squeezing into the nearby right orbit and large subcutaneous periorbital subcutaneous emphysema. The patient was treated conservatively with antibiotics and admitted to the hospital for five days. Subsequently, he made a full recovery with resolutions of all symptoms and was discharged home.