A Case of Orbitocranial Penetrating Injury
Keywords:
Orbitocranial penetrating injury, metal rodAbstract
Objective: To report a case of right orbitocranial penetrating injury by a metal rod. Case report: A 10-year-old boy alleged right orbitocranial injury with a metal rod penetrating from the right superior orbital edge. The right globe was displaced inferiorly with mechanical restriction of extraocular muscles movement (EOM). Right eye visual acuity (VA) was perception of light with negative reverse relative afferent pupillary defect (RAPD).  Computed tomography of the orbit and brain revealed metal rod penetrating the supero-temporal aspect of the right orbit with right orbital roof fracture. Operation was performed by multidisciplinary team. Upon metal rod removal, there was right orbital roof defect with pulsation of the right globe. However, exploratory craniotomy revealed intact dura matter with no subdural haemorrhage. Post-operatively, there was right eye mild proptosis with EOM restriction. The right VA was improved from 6/60 at 1-week post operation to 6/6 at 2-months follow-up with resolution of proptosis. There was EOM restriction over upper and lower gazes due to the presence of symblepharon, which then was resolved after symblepharon release. Conclusion: Orbital penetrating injury requires a multidisciplinary involvement and with globe preservation leads to a better visual outcome.ÂReferences
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