Anesthetic Considerations for Removal of Bilateral Orbital Foreign Bodies With Suspected Carotid Artery Involvement:...

Penetrating ocular trauma and carotid artery involvement each present distinct anesthetic challenges. In patients with suspected open globe injuries, increases in intraocular pressure must be minimized through careful anesthetic and airway management. Concurrent carotid artery involvement carries the risk of catastrophic hemorrhage and requires invasive monitoring and multidisciplinary coordination. We report the anesthetic management of a 74-year-old male presenting with bilateral orbital penetration by ballpoint pens, with imaging revealing the right pen abutting the internal carotid artery. This case highlights key anesthetic strategies and the importance of coordinated endovascular and surgical planning to ensure patient safety.