Large organic orbitocranial foreign body

Considerations for a Retained Foreign Body in the Posterior Orbital Apex

Orbital foreign bodies must be approached with complex considerations involving their precise location and composition in order to adequately guide management. Physicians must carefully weigh the advantages and risks of surgical and medical intervention compared to conservative management. We present a case of a male patient with penetrating trauma to the eye that resulted in open globe injury and orbital foreign body, presumed metallic, at the posterior orbital apex near the optic nerve. As such, despite the uncertainty of the exact composition of the object, the medical team and patient agreed to conservative management given its high-risk anatomical location.

An Eye Capturing Clutch - An Orbital Foreign Body

Foreign bodies inside the orbital cavity are rare. They may lead to serious complications, depending on their nature, size and mechanism of injury. A 29-year-old male presented with a motorcycle handle embedded in his left orbit, with the vision unaffected. Active wound bleeding, increasing hematoma, a low haemoglobin level, signs of hypovolemic shock, ocular acuity and mobility were investigated. A computed tomography scan revealed a long bent metallic object lodged between the globe and floor of the left orbit with fracture of the medial orbital wall and ethmoidal hemosinus with an intact cribriform plate of the ethmoid. An interdepartmental collaborative effort of Oculoplasty, Oro-Maxillofacial and Neurosurgery were utilized in the removal of the foreign body. The patient recovered well after the surgery and a course of antibiotic therapy.

A single large round-tipped foreign body in orbit composed of both metal and plastic is an extremely rare incident and fortunately in our case, was relatively harmless despite its large size. The diagnosis and management of intraorbital foreign bodies must be tailored according to their type and a proper localisation by all possible means, blunt dissection, careful haemostasis aided with good lighting, and exposure helps in their atraumatic removal.