Case of an Intra-orbital Foreign Body

Foreign Body
Piece of plastic removed from the orbital cavity. Source: BMC Surgery

This case describes a 35-year-old male who presented to the emergency with a craniofacial trauma. The injury involved the right side of his face. Moreover, his eyelids were swollen and lacerated with tenderness in the region. He was conscious at the time of the presentation. However, his visual acuity in the right eye dropped down to no light perception. Doctors also noted a relative afferent pupillary defect along with restricted eye movements in his right eye.

Foreign Body on the CT Scan

Doctors performed a CT scan of the affected region. It revealed the presence of a material in the right orbit, posterior to the globe. Initially, doctors regarded it as a bony fragment from a skull fracture due to trauma. However, they also suspected a foreign body.

After the initial supportive care, doctors prepped the patient with antibiotics for surgery. Both neurosurgeons and ophthalmologists evaluated the patient’s case and decided to go forward with a cranial approach to explore the orbital cavity. There was no fracture in the superior orbital wall, ruling out any bony fragments. A thorough exploration of the orbital cavity revealed a foreign body which was actually a piece of plastic pipe that had fallen on the man’s head. Doctors removed the foreign body and restored the cranial vault using a titanium mesh.

Post-Operative Events

Post-operatively, doctors kept the patient on antibiotics for seven days to prevent any infections. The overall condition of the patient improved. However, the visual acuity of his right eye did not show significant improvement. Nevertheless, doctors discharged him from the hospital after 2 weeks.

What are the Odds of Foreign Body in the Orbit?

Intra-orbital foreign bodies are usually associated with high-speed craniofacial trauma such as due to gunshots or blunt objects. They can cause significant damage to the optic nerve and despite early intervention, it results in permanent visual loss.


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