Pencil into the orbit

Case Study

In 2011, a 6 year old boy with orbital trauma in the form of a foreign object having penetrated his right eye attended the Ophthalmology Department of Imam Khomeini Hospital in Kermanshah. According to his parents, he suddenly fell when playing and a pencil went directly into the upper part of his right orbit. The severity of the accident was such that the pencil was split in two, with half of it lodged in the upper cavity of his right orbit. Because the pencil had broken at the entry location, it was under no circumstances to be moved (Figure 1).

However, X-ray (Figure 2) showed a straight, hypodense object similar to the wood density of a pencil and with a hyperdense center consistent with the carbon density of a pencil at an indefinite depth in the retro-orbital space.

The patient was rushed to the operation room to try to save his eye. After general anesthesia and some superior conjunctival peritomy to the upper part of the conjunctiva at the entry point, the pencil was taken out of the orbit. The pencil was 7cm long ( Figure 3).

The CT-scan showed the complete removal of the foreign object from the orbit and no ocular or brain damage. The patient was supervised for two months after surgery and showed no adverse effects from the trauma. The visual acuity of the patient was 10/10.

Credits: Mehdi Moradinazar, ncbi