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Case Reports
. 2018 Oct;66(10):1511-1513.
doi: 10.4103/ijo.IJO_150_18.

A challenging case of a large intraorbital foreign body perforating the nasal septum in a child

Tanie Natung  1 , Wakaru Shullai  1 , Donbok Lynser  2 , Taraprasad Tripathy  2
Affiliations
Case Reports

A challenging case of a large intraorbital foreign body perforating the nasal septum in a child

Tanie Natung et al. Indian J Ophthalmol. 2018 Oct.

Abstract

A 5 year old boy with a history of fall from a height of about 4 feet, presented after one week with swelling, watering and discharge of the right eye. He had severe conjunctival chemosis with superior displacement of the globe. Computed Tomography (CT) showed a linear low attenuation tract in the right orbit extending from the inferolateral wall up to the left uncinate process of the ethmoid bone with increasing Hounsfield unit after 10 days. The parents did not agree for early exploration. After 10 days an exploration was done and a large linear and irregular wooden foreign body (FB) measuring 4.5 x 1.5 cm2 was removed from the right orbit and a smaller one from the nasal cavity. Four weeks post surgery, his vision was 6/9 in the right eye with the eyeball in the normal position. This case was challenging because of the late presentation, parents not agreeing for early exploration, difficulty in diagnosing by CT and a large and very deep penetrating FB.

Keywords: Foreign body; intra-orbital; nasal septum; wooden.

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Conflict of interest statement

There are no conflicts of interest

Figures

Figure 1
Figure 1
Clinical photo showing severe conjunctival chemosis of the Right eye with superior displacement
Figure 2
Figure 2
(a) Axial Computed Tomography (CT) showing a linear low attenuation track in right orbit extending from inferolateral wall to medial wall with attenuation values of -300 Hounsfield unit (HU) approximately. The medial wall of right orbit and nasal septum is fractured. (b) A repeat CT scan after 10 days showing an increase in the attenuation values of the linear track in right orbit extending from inferolateral wall to medial wall to approximately -30 HU. (c) CT coronal section showing a linear and irregular wooden IOFB with superiorly displaced globe
Figure 3
Figure 3
Photo showing a linear and irregular wooden FB measuring 4.5 × 1.5 cm2 after removal
Figure 4
Figure 4
Clinical photo four weeks after the surgery, showing total resolution of the periorbital oedema and conjunctival chemosis with inferior corneal opacity with vascularization. The eyeball is in its normal position
See this image and copyright information in PMC

Comment in

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