Role of computed tomography in the assessment of intraorbital foreign bodies

Intraorbital foreign bodies (IOFBs) are a common occurrence worldwide and happen at a frequency of once in every 6 cases of orbital trauma. An orbital foreign body may produce a variety of signs and symptoms related to its size, composition, and ballistics. Retained foreign bodies may give rise to cellulitis, abscess, fistulas, and impaired vision and motility. Prompt detection and accurate localization of IOFBs are essential for the optimum management of patients, to enable the surgeon to plan the most atraumatic method of removing the IOFB. Computed tomography (CT) is very useful in determining the size of foreign bodies and localizing them as intraocular, extraocular, or retro-ocular. CT is generally considered the gold standard in the evaluation of IOFBs because it is safe to use with metallic IOFBs, excludes orbitocranial extension, and is also able to diagnose orbital wall fractures and orbital sepsis with high accuracy. Other potential complications excludible by CT are abscess formation in the orbit, bone, and brain. Magnetic resonance imaging is generally not recommended for the evaluation of the foreign bodies because of risks associated with magnetic metal.