Management of wooden foreign bodies in the orbit

Three large wooden foreign bodies were undetected in the orbit despite extensive evaluation and orbital exploration. In two cases there was motility disturbance from orbital inflammation that resolved after late spontaneous extrusion of the foreign material. Recurrent fistula unresponsive to antibiotics persisted in two cases until the wood extruded. Computerized tomography and ultrasonography failed to identify the foreign material. Orbital exploration without preoperative localization of the foreign body is usually contraindicated because proptosis, motility limitation, and fistula usually resolve after late spontaneous extrusion. In our cases and in the literature early exploration did not lead to complete extirpation of foreign material. We inform the patient of our diagnostic limitations and the prudence of conservative management.