PMC4008901_01
External photograph at presentation showing left eye eccentric proptosis and discharging sinus at medial canthus
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F1
On examination there was eccentric proptosis, discharging sinus at medial canthus, lid edema, chemosis, relative afferent pupillary defect (RAPD), restricted extraocular movements in all gazes [Figure 1], intraocular pressure within normal limits and no light perception due to compressive optic neuropathy.
Computed tomography orbit coronal scan showing a retained foreign body along medial orbital wall and the medial rectus muscle and surrounding reactionary granuloma, blow out fracture of orbital roof, medial wall, and floor
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F2
Computed tomography (CT) scan showed a retained foreign body along medial orbital wall, medial rectus muscle and surrounding reactionary granuloma, blow out fracture of orbital roof, medial wall, and floor [Figure 2].
Magnetic resonance imaging orbits axial scan showing hyperdense linear structure along medial quadrant of left orbit measuring 2.17 x 0.59 cm with coexistent ethmoidal and maxillary sinusitis
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F3
Magnetic resonance imaging (MRI) showed hyperdense attenuation along the medial orbital wall suspected to be a retained foreign body [Figure 3] in the ethmoidal sinus and took expert opinion from an otorhinolaryngologist.
Multiple wooden foreign bodies of different sizes retrieved by transnasal endoscopic removal
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F4
Multiple wooden foreign bodies of varying sizes covered with granulomatous tissue were retrieved from the ethmoid sinus [Figure 4] through nasal endoscopy route.
External photograph (after endoscopic removal of foreign body) showing left eye in exotropia due to restrictive strabismus
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F5
Postoperatively, he was treated with oral antibiotics and analgesics following which proptosis subsided but there was residual restrictive strabismus [Figure 5] due to dense fibrosis and no light perception due to long standing compressive optic neuropathy.