Extracted Intra-Orbital Wooden Foreign Body Missed by the Primary Clinician

Abstract

Intra-orbital wooden foreign bodies pose a significant challenge for clinicians as they are uncommon and difficult to diagnose due to their unique characteristics. Surgery is usually recommended as the presence of a foreign body can potentially induce severe complications, such as diplopia, proptosis, and loss of vision. However, the specific symptoms associated with these foreign bodies are not yet well understood and may, in some cases, take several years to manifest. Moreover, imaging studies have a high likelihood of failing to detect the presence of a foreign body. In this case, a 74-year-old man presented with worsening swelling and redness of the right lower eyelid. He had fell in his garden 6 months prior and underwent computed tomography, which did not reveal any evidence of foreign bodies in the orbit. Subsequently, he was treated for an optic canal fracture by an ophthalmologist. Based on the patient's symptoms and a secondary computed tomography scan, we performed surgery addressing the posttraumatic granuloma, abscess, and foreign body. During the procedure, a piece of wood was successfully extracted from his orbit. In conclusion, when patients experience orbital trauma and present with chronic symptoms, the possibility of a foreign body retained in the orbit should be considered.