Intraorbital wood foreign body

It is frequently difficult to identify and localize organic intraorbital foreign bodies despite modern day high-resolution imaging studies. Although there can be grave complications associated with retention of organic intraorbital foreign bodies, many believe that removal of such bodies in most cases is unwarranted. A high clinical suspicion, proper choice of imaging studies, and removal by a skilled orbital surgeon probably make the risk of surgical exploration and foreign body removal less than the risk of foreign body retention. We present a case of an intraorbital wood foreign body that required two separate explorations for retrieval. An initial intraconal exploration failed to locate the foreign body. Although the clinical suspicion was high, the imaging studies were equivocal, complicating the management. A second exploration yielded a large intraorbital wooden foreign body in the inferior extraconal space. The patient fully recovered and regained visual acuity of 20/20. The evaluation of such patients and details of management strategy are discussed.