Retained Bullet in the Orbit Following a Gunshot Wound: Management of Subsequent Complications

Gunshot wounds to the craniofacial region are often fatal, and isolated orbital involvement is exceptionally rare. Severe ocular and systemic complications, such as vision loss, neurological damage, and infections, can arise from high-velocity bullet injuries to the orbit. The case presented involves a male patient with two cranial impacts, one of which left a projectile lodged in the retrobulbar space. The initial treatment was surgical reparation of the wounds and observation. However, due to a persistent fever and the development of an abscess, the orbital projectile was removed. The patient's condition improved, but amaurosis remained. In this instance, timely surgical removal of the projectile, guided by a customized risk-benefit analysis, early localization using computed tomography for accurate assessment, and multidisciplinary management to address complex injuries were all crucial elements. Orbital injuries caused by firearms are uncommon and extremely complicated, necessitating timely and individualized treatment to optimize the prognosis. Clinical evaluation should always be the basis for projectile removal decisions, weighing potential risks against benefits.