CASE REPORT: DELAYED PRESENTATION OF INTRAORBITAL FOREIGN BODY (IOFB)

Chinawa N. E. and Odogo V.

ABSTRACT

Aim: To establish the role of plain radiograph in establishing a diagnosis of suspected metallic foreign body when the history is vague and more desirable investigation like CT scan are not affordable. Case Report: MT was a 40-year-old hunter who had a supposed rebound of bullet pellets into his right infraorbital area when he attempted shooting a wild animal. On presentation, globe remained intact but he had a scar in the infraorbital area with symblepharon in the inferior fornicial area. On palpation, there was a deep-seated object which was firmly adherent in this area. Patient was unable to do CT scan due to financial constraint but plain radiograph revealed an opaque comma shaped object which on surgical removal was confirmed bullet. Discussion: IOFB are commonly encountered in ophthalmic clinical practice. It is common among males between the ages of 25-39 years. There are cases where the presence of a foreign body may be difficult to guess, based on history or clinical examination. These cases would require imaging like Computerized tomography (CT). However due to financial constraint, many patients may be unable to do a CT scan. Cheaper imaging technique like plain radiograph (X-ray) which could give a relatively reliable result would have to be relied upon in such cases. Conclusion: Plain radiograph can play an invaluable role in establishing suspected metallic intraorbital foreign body especially when the history is vague and more sophisticated investigations are not affordable.

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