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[Wooden spike orbital injury]
R Kiel1, C Wiaux, P W Atipo-Tsiba
1Universitäts-Augenklinik Genf, Schweiz. kielralf@hotmail.com
Klinische Monatsblatter Fur Augenheilkunde
|March 24, 2005
Summary
A retained wooden foreign body caused severe eye swelling and vision loss. Magnetic resonance imaging (MRI) is crucial for diagnosing such intraorbital foreign bodies, leading to successful treatment.
Area of Science:
- Ophthalmology
- Medical Imaging
- Trauma Surgery
Background:
- Orbital foreign bodies can lead to severe complications if not promptly diagnosed and treated.
- Wooden fragments are particularly challenging due to their radiolucency and potential for tissue reaction.
Observation:
- A 71-year-old female presented with left periorbital swelling and reduced vision three days after a garden injury.
- Initial examination revealed a fluctuant swelling and pseudoptosis; X-rays were negative for foreign bodies.
- Purulent discharge and a wooden fragment were found upon wound exploration, with restricted ocular abduction.
Findings:
- Magnetic resonance imaging (MRI) identified a second intraorbital wooden foreign body and a medial orbital wall fracture.
- Surgical removal of both wooden fragments via anterior orbitotomy was performed.
- Histopathology confirmed organic material consistent with wood.
Implications:
- This case highlights the diagnostic limitations of X-rays for radiolucent foreign bodies like wood.
- MRI is essential for detecting retained intraorbital organic foreign bodies and associated injuries.
- Thorough wound inspection and advanced imaging are critical for managing high-risk penetrating eye injuries.