Penetrating orbital injury with cavernous sinus involvement

Penetrating orbital injuries may involve intracranial structures as well. We report an unusual case of permanent visual loss, temporary complete ophthalmoplegia, and penetration of the internal carotid artery following penetrating nail injury. CT scanning and arteriography are important diagnostic tests to consider prior to removal of an orbital foreign body. This case also demonstrates the importance of delaying repair of traumatic ptosis and ophthalmoplegia.