Late orbital floor implant migration presenting as recurrent episcleritis

A 53-year-old patient presented with recurrent epicleritis of the right eye for 6 months and progressive diplopia. He had a past history of orbital floor repair over 30 years. A CT scan showed a radiodense migrated orbital floor sheet implant in the maxillary sinus causing obstruction of the maxillary sinus ostium, secondary maxillary sinusitis with retrobulbar involvement. The silastic orbital implant was removed via a Caldwell Luc approach and resolution of the patient's symptoms and signs quickly ensued. We discuss this late complication of orbital floor fracture repair presenting initially as recurrent episcleritis and maxillary sinusitis with intraorbital extension. This report also emphasizes the importance of history taking.