A Case of an Intraorbital Wooden Chip Foreign Body Diagnosed and Removed Several Months after Injury Despite Repeated Imaging Study

Abstract

Intraorbital foreign bodies due to trauma are commonly encountered in clinical practice. However, organic foreign bodies, such as wood chips, can sometimes be difficult to diagnose. Here, we report the case of a patient with a wooden chip located intraorbitally that was not detected until spontaneous discharge, despite repeated diagnostic imaging. A 43-year-old intoxicated woman presented to our hospital with a bruised face and eyelid. The patient was diagnosed with conjunctivitis and iritis, but no foreign body was noted in repeated imaging studies since the first visit. Therefore, the patient was observed and managed conservatively. The patient returned to the hospital 114 days after the injury, with no improvement in her conjunctivitis. Examination revealed exposure of a foreign body in the lower eyelid conjunctiva, which was removed during emergency surgery. There are no clear criteria for imaging diagnosis of organic foreign bodies in the body. However, it may be possible to detect them by changing the imaging conditions and examining the computed tomography values in detail. In addition, in case of persistent clinical symptoms, such as inflammation, the image examination should be reviewed. In eyelid trauma, the medical history is sometimes unknown, so it must be remembered that a detailed examination and, in some cases, clinical symptoms are important in making a diagnosis.