PMC5362851_01
Patient at initial presentation showing severe endophthalmitis, secondary glaucoma and exposure keratitis of the left eye
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In the OS the menace response and the dazzle reflex were negative, the blink reflex was incomplete owing to globe enlargement, the cornea reflex was decreased owing to corneal permanent exposure and the pupillary light reflexes were impossible to evaluate owing to severe corneal opacity (Figure 1).
(a) Dorsoventral radiograph of the skull showing an intraocular metallic foreign body, compatible with a sewing needle, measuring approximately 6 cm in length, located in the interior of the left orbit, in contact with the posterior orbit. (b) Laterolateral radiograph of the skull showing an intraocular metallic foreign body with a small hole in its ventral extremity (arrow), compatible with a sewing needle, measuring approximately 6 cm in length, located in the interior of the left orbit. The endotracheal tube is visible inside the mouth and trachea
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Skull radiographs (dorsoventral and laterolateral view) showed an intraocular linear metallic foreign body compatible with a sewing needle, measuring approximately 6 cm in length, located inside the left ocular globe, in close contact with the back of the orbit, as can be seen in Figure 2.
During the enucleation procedure, the globe was carefully removed from the orbit, while trying to prevent any leakage from the contaminated material inside the vitreous cavity, leaving the sewing needle (once inside the ocular globe) behind, attached to the posterior part of the orbit (arrow)
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The globe was carefully removed from the orbit, while trying to prevent leakage of contaminated material from the vitreous cavity through the needle entry point, leaving the sewing needle attached to the back of the orbit (Figure 3).
When the needle was pulled away, a piece of thread (approximately 10 cm long) attached to it and previously lodged in the oesophagus was also retrieved, demonstrating that the linear foreign body had migrated retrogradely from the mouth to the orbit through the pterygopalatine fossa
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When the needle was pulled away, a piece of thread approximately 10 cm long attached to it was also retrieved, which demonstrated that the linear foreign body had migrated retrogradely from the mouth to the orbit through the pterygopalatine fossa (Figures 4 and 5).
Curved enucleation scissors, resected ocular globe and linear foreign body with the sewing needle and the attached thread
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When the needle was pulled away, a piece of thread approximately 10 cm long attached to it was also retrieved, which demonstrated that the linear foreign body had migrated retrogradely from the mouth to the orbit through the pterygopalatine fossa (Figures 4 and 5).