Transorbital injury from a harpoon involving the paranasal sinuses

A harpoon accidentally entered the right eye of a 15-year-old boy. No loss of consciousness occurred. After neuro-radiological assessment, the object which had penetrated the sphenoid sinuses was removed without mishap. He made a good recovery but has, as permanent deficits, an inferotemporal field defect, diminished visual acuity with optic atrophy, a sensory pupillary defect and right ptosis. The need for hospitalisation and a team approach to penetrating injuries of the face is discussed.