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Management of Intra-orbital Wooden Foreign Bodies at a Resource-limited Setting in Sub-Saharan Africa
Niranjan K Pehere1, Unity Fahn Dokie1, George Tamba Bornguoi1
1Liberia Eye Center, L V Prasad Eye Institute Liberia (Inc.), John F Kennedy Memorial Medical Center, Monrovia, Liberia.
Introduction:
Wooden intra-orbital foreign bodies (IOrbFBs) have a high risk of microbial contamination needing timely diagnosis and treatment. We describe management of three cases of wooden IOrbFB at a resource-limited setting in Liberia.
Materials And Methods:
This is a retrospective case series of three patients with IOrbFB managed at the Liberia Eye Center, Monrovia, Liberia. Demographic details, mode of injury, ocular examination findings, neuroimaging, surgical treatment, and clinical findings on post-operative follow-up visits were noted for each patient.
Results:
All the three patients were young, male, and were involved in traumatic incidents (fall in two cases and road traffic accident in one case). Two patients with visible wooden FB presented within 48 h of injury and one patient with occult FB presented after 2 weeks. All patients underwent orbital imaging followed by surgical exploration for the removal of FB. One patient also had coexisting orbital cellulitis, which was successfully treated medically. One of these patients had best corrected visual acuity of 20/20, and the other two had no perception of light in the affected eyes.
Conclusion:
History of injury with a wooden material should raise a high index of suspicion for an occult IOrbFB. Timely diagnosis and treatment of wooden IOrbFB can be challenging in a resource-limited setting, but with a systematic approach they can be treated satisfactorily.
Insights
Wooden intra-orbital foreign bodies (IOrbFBs) require prompt diagnosis and treatment due to infection risk. This case series highlights successful management of three IOrbFB cases in a resource-limited setting.
Area of Science:
- Ophthalmology
- Trauma Surgery
Background:
- Wooden intra-orbital foreign bodies (IOrbFBs) pose a significant risk of microbial contamination.
- Timely diagnosis and management are crucial for favorable outcomes.
Observation:
- A retrospective case series of three patients with IOrbFB managed in Liberia.
- Patients included young males with traumatic injuries; presentation varied from within 48 hours to 2 weeks.
- Management involved orbital imaging and surgical FB removal, with one case of coexisting orbital cellulitis.
Findings:
- Two patients with visible FB presented early, while one with occult FB presented later.
- Surgical exploration and removal were performed for all.
- Visual outcomes varied, with one patient achieving 20/20 vision and two experiencing no light perception.
Implications:
- A high index of suspicion for IOrbFB is warranted with a history of wooden material injury.
- Effective management of IOrbFB is achievable in resource-limited settings with a systematic approach.
- Early detection and intervention are key to improving visual prognosis in orbital trauma.
