Authors:

Abstract

Aim: To report an interesting case of diplopia, caused by an initially undiagnosed intra-orbital foreign body, which resolved following its removal.

Method: The ease is presented of a 16-year-old boy who injured his right eye by riding a quad bike into a hedge. Ophthalmic and orthoptic findings with Hess charts are documented, with a photograph of the orbital foreign body. Investigation and management are described.

Results: The boy presented to the accident and emergency department reporting a twig had poked his right eye following the accident. Chloramphenicol was prescribed and the boy was discharged. Four days later the boy presented with orbital swelling with vertical and torsional diplopia. Examination revealed restriction of ocular movement and a radiograph revealed no orbital or foreign body. The orbital swelling and restriction of ocular movement increased and 18 days after the injury a 12 mm long thorn was removed from the upper nasal conjunctiva. Full recovery of ocular movement and swelling occurred in the weeks following removal of the foreign body.

Conclusion: Careful investigation and follow-up of such cases is needed as intra-orbital foreign bodies are difficult to detect and a high level of suspicion is needed.

Keywords: Diplopia, Intra-orbital foreign body