Clinical Review

Lesson of the week

Two cases of retention of wooden foreign bodies in orbit of eye

BMJ 1998; 316 doi: 10.1136/bmj.316.7141.1363 (Published 2 May 1998)
Cite this as: BMJ 1998;316:1363

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  1. M D Tsaloumas, specialist registrar,
  2. T Potamitis, senior registrar,
  3. E E Kritzinger, consultant ophthalmologist
  1. Birmingham and Midland Eye Centre, City Hospital NHS Trust, Birmingham B18 7QH
  1. Correspondence to: Miss Tsaloumas
  • Accepted 31 October 1997

Beware of retained wooden foreign bodies associated with ostensibly minor injuries in the vicinity of the orbit

Missed intraorbital foreign bodies may lead to sight threatening and life threatening complications.1 Although penetrating injuries of the orbit are usually obvious, cases of retention of intraorbital foreign bodies after apparently minor trauma have been reported and continue to be missed. 2 3 We present two cases of intraorbital wooden foreign bodies that were initially undetected. A high index of suspicion and a detailed history and examination are important in suspected cases of intraorbital foreign bodies.

Case reports

Case 1

A 20 month old girl presented to the paediatric accident and emergency department having sustained a fall indoors near a fireplace. A laceration of the right cheek was closed with sterile skin closures (3M, St Paul, MN) and she was discharged. Forty eight hours later she presented with persistent swelling and erythema of the cheek and lower lid. She was admitted and given intravenous antibiotics. Plain x ray films of the facial and orbital bones were unremarkable.

One week after the original injury an ophthalmic opinion was sought. Visual acuity tested with Teller …

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