Penetrating orbital trauma by a large metallic foreign body: A case report

Intraorbital foreign bodies are not uncommon, and the outcome is not always satisfying after management. A 41-year-old male presented to the ER with a history of occupational trauma 30 minutes before presentation. On non-contrast CT, a 4 cm curved nail was visualized near the lateral orbital wall penetrating the zygomatic buttress with no evidence of retrobulbar haemorrhage or bulbus oculi perforation. Under coverage of proper antibiotics, the nail was removed using lateral eyebrow approach keeping the globe intact, and the wound was closed in layers. The injured eye demonstrated free range of movement postoperatively. The patient was then referred for retinal repair surgery. Early management and meticulous extraction can lead to satisfying outcomes even with large foreign bodies.