Spring Door Closer Entrapment of the Upper Eyelid: A Pediatric Periocular Foreign-Body Injury With a Favorable...

Ocular trauma in children is an important cause of avoidable visual morbidity, with potential psychosocial, educational, and quality-of-life consequences. Domestic spring door closers, commonly called "trapdoor springs" in Ghana, may cause significant periocular injury when an exposed hook is accidentally encountered; however, this mechanism is rarely described in the ophthalmic literature. We report a 10-year-old girl who presented shortly after a household accident with a metallic spring door closer hook embedded in the left upper eyelid. Marked eyelid edema, mechanical ptosis, pain, tearing, and distress prevented reliable initial assessment of visual acuity, pupillary responses, ocular motility, and the anterior and posterior segments of the affected eye. Non-contrast orbital computed tomography (CT) demonstrated a metallic foreign body confined to the upper eyelid and periocular soft tissues, without globe penetration, orbital wall fracture, or retrobulbar hemorrhage. The foreign body was removed in theater under general anesthesia by controlled disengagement without forceful traction. Intraoperative findings included corneal and conjunctival abrasions and a 6 mm conjunctival laceration, which was repaired with 8-0 Vicryl absorbable suture. Postoperative care included tetanus prophylaxis, analgesia, topical antibiotic-corticosteroid therapy, lubrication, and scheduled review. At 2 months, unaided visual acuity was 6/6 and intraocular pressure was 12 mmHg in both eyes; ocular motility was full, the anterior and posterior segments were normal, and there was no evidence of globe injury. This case highlights the importance of prompt CT localization, avoidance of unsafe bedside traction, controlled theater removal with ocular-surface protection, meticulous repair, structured follow-up, and household safety measures.