Unrecognized intraorbital wooden foreign body

Area of Science:

• Ophthalmology
• Radiology
• Plastic Surgery

Background:

• Intraorbital wooden foreign bodies pose diagnostic challenges due to their radiolucent properties.
• Delayed diagnosis and management of these foreign bodies can result in significant complications.

Purpose of the Study:

• To highlight the diagnostic difficulties and potential sequelae of intraorbital wooden foreign bodies.
• To emphasize the importance of timely recognition and management in preventing severe outcomes.

Main Methods:

• Case report of a 56-year-old male with a delayed diagnosis of an intraorbital wooden foreign body.
• Initial presentation with eyelid laceration, followed by suspected pneumophthalmos.
• Subsequent development of orbital infection, leading to advanced imaging and surgical intervention.

Main Results:

• Initial computed tomography (CT) scans failed to identify the wooden fragment.
• Delayed diagnosis nearly 2 months post-injury revealed a large intraorbital wooden foreign body.
• Surgical removal was successful, but prolonged infection caused irreversible damage to the superior rectus muscle, resulting in persistent upgaze diplopia.

Conclusions:

• Clinicians must maintain a high index of suspicion for intraorbital wooden foreign bodies, even with initial negative imaging.
• Prompt and accurate diagnosis is crucial to prevent severe complications such as permanent muscle damage and visual impairment.
• This case underscores the grave prognosis associated with delayed management of intraorbital wooden foreign bodies.