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Delayed Sensory Exotropia With Retained Metallic Intraorbital Foreign Body.

Ryung S Lee, Richard F Sofoluke, Saif A Alryalat

    Journal of Pediatric Ophthalmology and Strabismus
    |January 23, 2025
    PubMed
    Summary
    This summary is machine-generated.

    This case study details a rare instance of a retained intraorbital foreign body from a childhood BB gun injury. It highlights the long-term development of sensory exotropia, a delayed complication of traumatic sclopetaria.

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    Area of Science:

    • Ophthalmology
    • Traumatic Eye Injury
    • Pediatric Ophthalmology

    Background:

    • Sclopetaria, a result of high-velocity projectile injury, can cause retinal and choroidal damage without globe rupture.
    • Delayed complications of sclopetaria, particularly involving ocular motility and alignment, are not well-documented.
    • Retained intraorbital foreign bodies present unique management challenges.

    Purpose of the Study:

    • To report the longest documented case of a retained metallic intraorbital foreign body.
    • To describe the development of delayed sensory exotropia following childhood traumatic sclopetaria.
    • To emphasize the importance of considering late sequelae in managing such injuries.

    Main Methods:

    • Case report of a 9-year-old girl with a BB gun injury to the left eye.
    • Ophthalmic examination including visual acuity and pupillary assessment.
    • Orbital computed tomography (CT) for foreign body localization.
    • Longitudinal observation of ocular alignment and motility.

    Main Results:

    • A retained metallic foreign body (BB) was identified in the orbit via CT scan.
    • The patient developed significant delayed sensory exotropia (30 prism diopters).
    • No immediate complications related to the retained foreign body were observed.

    Conclusions:

    • Sclopetaria can have late-onset ocular motility complications like sensory exotropia.
    • Retained intraorbital foreign bodies require careful long-term monitoring for delayed sequelae.
    • Surgical management of delayed sensory exotropia in this context may require specific precautions.