Intra-Orbital Foreign Body in a 7 Month Old

Orbit And Oculoplasty

Abstract

Introduction: A case of orbital trauma with retained intraorbital foreign body demonstrating the importance of appropriate imaging  technique in management and prevention of mortality.

Case Description: OT, a 7month old female, was referred to our eye clinic with one month history of right eye swelling and discharge  following trauma from a stick that was thrown at her. She had received first aid at a private facility and a piece of wood was removed at  the referring hospital a week post trauma. She presented with features suggestive of an orbital abscess. The right globe was intact,  the left eye was normal. The possibility of a retained foreign body was entertained. A cranial CT scan was immediately requested for  but could not be done due to financial constraints on the part of parents. She was admitted, immediately had incision and drainage  done. Topical and parenteral medication were commenced. Orbito-ocular ultrasound scan was normal. Culture of aspirate obtained  from the incision and drainage done at admission yielded growth of E.coli. Wound exploration was done on the fifth day on admission  and a wooden fragment (13mmx3mm) was removed. Lid odema resolved but a persistently discharging sinus despite use of  sensitivity-guided antibiotics warranted an appeal fund to finance a cranial CT scan, which was done after two weeks on admission.  Result showed a retained foreign body at the orbital roof. Surgical exploration was immediately repeated with the maxillofacial  surgeons[1]. Four pieces of wood measuring 34mmX12mm, 20.5mmX5.5mm, 8mmX6mm, 10mmX4.5mm were removed. She was  discharged home seven days after.