Intraorbital wooden foreign bodies: case series and literature review

You, Ya-Yan; Shi, Bingjie; Wang, Xinyan; Chen, Jin; Zhengrong, Wang; Wang, Xinghua; Jiang, Fei

doi:10.18240/ijo.2021.10.21

Cited by 18 publications

(9 citation statements)

References 40 publications

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“…Wood's porous organic nature makes it an ideal breeding ground for bacteria and other germs that could cause infection if left untreated ( 5 , 28 , 29 ). It has been reported that more than half of patients with IOWFBs develop an orbital infection ( 9 , 30 , 31 ), necessitating the removal of all wooden foreign bodies. Large foreign bodies should also be removed surgically because they always cause eye movement disorders, oppressive symptoms, and visual dysfunction ( 3 , 18 ).…”

Section: Discussionmentioning

confidence: 99%

Clinical analysis of 96 patients with intraorbital foreign bodies: A 10-year retrospective study

You

Wang²,

Cheng³

et al. 2022

Front. Med.

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IntroductionTo investigate the clinical manifestations, diagnosis, and surgical treatment of intraorbital foreign bodies (IOFBs).MethodsPatients with IOFBs were enrolled from Wuhan Union Hospital between January 2011 and January 2021. Demographic and clinical information was extracted, including gender, age, cause and entrance of the trauma, material, size and quantity of foreign body, visual function, ocular complications, imaging findings, and surgical intervention. The patients were divided into two groups according to the timeline, group A (from January 2011 to December 2015, n = 39) and group B (from January 2016 to January 2021, n = 57).ResultsThe 96 patients (81 men and 15 women) were enrolled in this series, with a median age of 39.5 (1.6–76.0) years. Work-related injuries were the cause of IOFBs in 45 individuals (46.9%). Three patients (3.3%) presented severe visual impairment, and 39 patients (42.4%) presented blindness. The majority of foreign bodies were metal (44.8%), followed by wood (26.0%). Computed tomography (CT) and magnetic resonance imaging (MRI) were performed, respectively, on 89 (92.7%) and 21 (21.9%) patients with IOFBs, in which the detection rate was 80.9% for CT and 81.0% for MRI. Among the 25 patients with intraorbital wooden foreign bodies (IOWFBs), the utilization and detection rates of MRI were 50.0% and 40.0% in group A, and 93.3% and 92.9% in group B, with significant differences in both rates between the two groups (both P < 0.05). The IOWFBs detection rate in MRI was significantly higher than that in CT (78.9% vs. 45.8% overall and 92.9% vs. 53.5% in group B). The detection rates of IOFBs and IOWFBs in initial surgery were statistically different between the two groups, of which the rates were 84.6% and 40.0% in group A and 98.2% and 93.3% in group B. The reoperation rate of IOWFBs in group B (20.0%) was significantly lower than that in group A (70.0%).ConclusionIOFBs were mainly caused by work-related injuries and might lead to serious visual impairment. The application and detectability of MRI in IOWFBs improved in recent years, and MRI presented better detectability than CT in diagnosing IOWFBs. Thus, MRI should be recommended despite negative CT findings.

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Section: Discussionmentioning

confidence: 99%

Clinical analysis of 96 patients with intraorbital foreign bodies: A 10-year retrospective study

You

Wang²,

Cheng³

et al. 2022

Front. Med.

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“…4 Currently, CT scan remains the gold standard but it has inconsistent reported detection rates ranging from 42% to 72%. 1,2,[5][6][7] The type of wood, density, and freshness leads to variable signal densities on CT. 8 Wooden foreign bodies in the orbit are challenging to diagnose and easily missed on imaging. A clear history with the presumed clinical diagnosis should be provided to radiology for careful assessment of images.…”

Section: Discussionmentioning

confidence: 99%

A Computed Tomography Scan Near Miss of an Intraorbital Wooden Foreign Body

et al. 2022

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When intraorbital wooden foreign bodies are missed, the consequences can be devastating. While the gold standard diagnostic imaging is computed tomography (CT), it has low sensitivity. We present a 61-year-old man with a bamboo injury to his right eye. He underwent two CT scans that failed to raise the possibility of intraorbital foreign bodies. Upon additional review, a rectangular-shaped pocket of air was identified in the orbit which was most consistent with wooden foreign bodies based on the clinical history. A combined mid-lid approach followed by a transconjunctival and transcaruncular extension were employed to remove several wooden splinters. Postoperatively, due to recurrent orbital compartment syndrome, he required a second decompression with an inferior rim osteotomy. He had good recovery at 3 months follow-up. Overall, intraorbital wooden foreign bodies are challenging to diagnose due to imaging limitations. Providing a clear history and suspected diagnosis to radiology is critical for diagnosis.

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“…The infection may manifest as orbital cellulitis, abscess formation, and even intracranial infection. Detection of wood in the eye is challenging because it is carbon-containing and not visible on conventional x-ray may not image well on CT or MRI [ 169 , 170 ]. If the chip is small and on the surface, it may be flushed with eyewash; however, deeper penetration shards may require surgical intervention and antibiotic treatment ( Figure 1 ) [ 171 ].…”

Section: Workplace Ocular Injuriesmentioning

confidence: 99%

Toxic External Exposure Leading to Ocular Surface Injury

Rauchman

Locke

Albert

et al. 2023

Vision

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The surface of the eye is directly exposed to the external environment, protected only by a thin tear film, and may therefore be damaged by contact with ambient particulate matter, liquids, aerosols, or vapors. In the workplace or home, the eye is subject to accidental or incidental exposure to cleaning products and pesticides. Organic matter may enter the eye and cause infection. Ocular surface damage can trigger a range of symptoms such as itch, discharge, hyperemia, photophobia, blurred vision, and foreign body sensation. Toxin exposure can be assessed clinically in multiple ways, including via measurement of tear production, slit-lamp examination, corneal staining, and conjunctival staining. At the cellular level, environmental toxins can cause oxidative damage, apoptosis of corneal and conjunctival cells, cell senescence, and impaired motility. Outcomes range from transient and reversible with complete healing to severe and sight-compromising structural changes. Classically, evaluation of tolerance and safety was carried out using live animal testing; however, new in vitro and computer-based, in silico modes are superseding the gold standard Draize test. This review examines how environmental features such as pollutants, temperature, and seasonality affect the ocular surface. Chemical burns to the eye are considered, and approaches to protect the ocular surface are detailed.

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Intraorbital wooden foreign bodies: case series and literature review

Cited by 18 publications

References 40 publications

Clinical analysis of 96 patients with intraorbital foreign bodies: A 10-year retrospective study

Clinical analysis of 96 patients with intraorbital foreign bodies: A 10-year retrospective study

A Computed Tomography Scan Near Miss of an Intraorbital Wooden Foreign Body

Toxic External Exposure Leading to Ocular Surface Injury

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