Computed tomography in penetrating wounds of the orbit with retained foreign bodies

Penetrating wounds of the orbit can have serious immediate and delayed effects on the eye and the CNS. Infection, vessel erosion, or interference with ocular function necessitates removal of the foreign object. Precise localization of the retained material and its relationship to the globe, extraocular muscles, optic nerve, and brain is essential, when surgery is contemplated. We describe two children with retained foreign bodies that required removal. Computed tomography (CT) was essential in one instance in planning the surgical approach. In the other patient, the retained foreign body and an associated brain abscess were recognized only by CT. The contribution of CT to the assessment of retained foreign bodies is discussed and its present limits are defined. Computed tomography is highly recommended as the single most informative diagnostic modality for this type of injury.