PMC4927210_01
Patient on initial presentation showing significant right-sided peri-orbital oedema and sub-conjunctival haemorrhage with mild infra-orbital ecchymosis. Smaller laceration/abrasion injuries to forehead can also be seen.
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On presentation, the patient had significant peri-orbital oedema around the right eye and a sub-conjunctival haemorrhage was visible (Figures 1 and 2).
Patient on initial presentation showing significant right-sided peri-orbital oedema and sub-conjunctival haemorrhage with mild infra-orbital ecchymosis.
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On presentation, the patient had significant peri-orbital oedema around the right eye and a sub-conjunctival haemorrhage was visible (Figures 1 and 2).
Occipitomental view plain film radiograph demonstrating a large radio-opaque mass over the right orbit.
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A standard occipitomental plain film view was taken (Figure 3).
(a-c) Head CT scan, selected axial plane slices demonstrating a right-sided retro-orbital area of hyperattenuation in direct contact with superior rectus, as well as smaller hyperattenuation areas in the pre-septal soft tissues.
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Upon reviewing the CT study, multiple radio-opaque areas of hyperattenuation were detected in and around the right orbit (Figure 4).
Intra-operative radiographs: (a) prior to removal of large glass fragment - instrument angulation and position seen in a superior pathway of approach to the foreign body; (b) following removal of glass fragment indicating complete removal.
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Complete removal was verified with another intra-operative radiograph (Figure 5).
Hess charts showing improvement in right eye restriction over a 5-month period. (a) Post-operatively indicating a remaining restriction in elevation. (b) Two months progress indicating improvement and a reduction in restriction observed. (c) Further 3 months progress indicating a return to a state of relative normality.
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Over the following 5-month long-term follow-up, the patient had three Hess chart plottings undertaken that indicated a significant improvement over time, returning to a relative state of normality (Figure 6).