Unusual Penetrating Injury of the Orbit

Occult Orbital Injury with Dagger Fragment with Resulting Pneumocephalus

“…Penetrating orbitocranial injuries by nonmissile low velocity particles are quite uncommon in the literature [ 16 ]. Traumatic eye injuries due to large retained foreign bodies are even more unusual with only a few cases of a retained knife affecting the orbit [ 3 – 11 ]. Only one case of an intraorbital retained knife undetected during external examination and diagnosed by image tests has been reported [ 3 ].…”

“…Traumatic eye injuries due to large retained foreign bodies are even more unusual with only a few cases of a retained knife affecting the orbit [ 3 – 11 ]. Only one case of an intraorbital retained knife undetected during external examination and diagnosed by image tests has been reported [ 3 ]. The visual prognosis is often poor in these cases because of severe ocular damage.…”

“…Suspicion is critical in the diagnosis of a hidden foreign body. In such cases the diagnosis may be delayed until complications develop weeks or months later [ 2 , 3 , 7 , 8 , 12 ].…”

“…Eyelid or periocular wounds may be the only initial clinical sign of a penetrating orbitocranial foreign body [ 2 ]. Retained orbital dagger fragments are rare [ 3 – 11 ]; we present a case in which an unnoticed dagger fragment, only detected by image tests, caused eyeball perforation and orbital fracture with pneumocephalus. Transorbital penetrating brain injury with open globe is an unusual occurrence, representing about 0.4% of all head injuries [ 12 ].…”

Orbitocranial Foreign Body

“…When the pen was removed through the orbit, there remained a right spastic hemiplegia. The case of Lee and Lin [8] illustrates the possibility of overlooking the intracranial extension of the orbital wound. Nine days after the occurrence of what was thought to be only an orbital wound, a knife blade was found to be present, extending from the superior orbital fissure into the middle cranial fossa.…”