A case of pediatric ocular trauma caused by a green-colored pencil

We describe the case of a 6-year-old boy who presented with a right eye bruise after hitting the corner of a chair. Although slit-lamp microscopy revealed only conjunctival lacerations, B-scan ultrasound and computed tomography of the right eye orbital region showed high-intensity reflections and a high-density area, respectively. Suspecting an intraorbital foreign body, we reinterviewed the patient, who admitted to falling while holding a green-colored pencil. The patient was taken for surgery under general anesthesia, and a yellow, liquified muddy foreign body was located under the nasolateral Tenon's capsule, adjacent to the medial rectus muscle, and removed. Eyelid swelling, conjunctival chemosis, and severe pain were noted postoperatively. Intravenous cefozopran hydrochloride (900 mg/day) and oral steroids (20 mg/day) were administered for inflammation. Colored pencils containing kaolin can cause severe inflammation, necessitating urgent surgical removal.