Clinical Presentation and Management Strategies in Intraorbital Foreign Bodies

Area of Science:

• Ophthalmology
• Trauma Surgery
• Medical Imaging

Background:

• Penetrating orbital injuries can result in retained intra-orbital foreign bodies (IOrbFBs).
• Prompt and accurate diagnosis is crucial for effective management and visual preservation.

Observation:

• A retrospective case study reviewed seven patients with IOrbFBs following penetrating orbital trauma.
• Patient demographics, injury mechanisms, foreign body types (plastic, wood, metal), clinical presentations, and imaging findings were analyzed.
• Foreign body locations included inferior and medial orbits, with initial visual acuity ranging from normal to no light perception.

Findings:

• Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) aided in diagnosis, though plastic and wooden foreign bodies presented imaging challenges.
• Surgical intervention was performed in five cases, while two were managed conservatively.
• Favorable outcomes were achieved even without surgical removal for inert metallic/inorganic IOrbFBs.

Implications:

• Individualized treatment strategies are essential, balancing the risks of foreign body retention against surgical intervention.
• The nature of the foreign body significantly impacts diagnostic imaging and management decisions.
• Understanding the limitations of imaging for certain materials like plastic and wood is critical for ophthalmologists and trauma surgeons.