An interesting case of metallic foreign body (Nail) in the right orbit

Clinical details:

13 years old male patient came to the OPD with h/o injury just below right eye. When he came the injury was 4 days of duration. He had undergone wound suturing as soon as he sustained the injury.

On examination:

Proptosis (mild) of right eye+
Sutured wound seen just below right orbit. wound had healed.
Upwards movement of eye was restricted.
Lateral movements of the eye was normal

Investigations

orbit_fbxray.jpg

Shows metallic foreign body inside the right orbit.

orbit_fb.jpg

CT scan paranasal sinuses shows metallic foreign body in the floor of right orbit

Patient was taken up for surgery under general anesthesia. The metallic foreign body was removed via right infraorbital incision. This was preferred because he already had the sutured scar in that area.

Surgical video clipping:

Discussion:

This case is presented for its rarity. Without proper history it is very difficult to diagnose orbital foreign bodies inside the orbit. Retained foreign bodies in the orbit can cause:

1. Orbital hematoma
2. Orbital cellulitis
3. Ocular dysmotility
4. Proptosis
5. Orbital abscess
6. Blindness

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