Bilateral Orbito-Ocular Gunshot Injury in a Nigerian Male: Case Report and Review of Literature

Orbito-ocular injuries with retained intra-orbital foreign bodies affecting both orbits are uncommon in civilian practice. This case report aims to highlight an unusual presentation of bilateral orbito-ocular injury with retained intra-orbital foreign bodies following accidental explosion of a locally fabricated dane gun. A 30-year-old male presented with a five day history of bilateral orbito-ocular injury sustained following an explosion of a dane gun he was fabricating. There was immediate loss of vision in both eyes, and initial treatment was sought at a nearby private general medical clinic. Visual acuity at presentation was no perception of light and light perception with inaccurate projection in the right and left eye respectively, and he had an open wound over the left cheek with retained intra-orbital foreign bodies on plain radiographs. He subsequently underwent wound exploration and closure with removal of the foreign bodies. Vision however remained poor and he was lost to follow-up after being referred for vitreo-retinal consultation. The attendant socio-economic impact on the individual and family following severe bilateral orbito-ocular injury could be enormous when it results in bilateral loss of vision in a young adult. Measures should thus be put in place to regulate the handling of firearms so as to possibly reduce the resultant morbidity from such injuries

Retained Intra-orbital foreign bodies : A Short Case Series

ABSTRACT Intraorbital foreign in different forms are seen quite commonly in all age groups. These objects can be classified according to their compositionas (1) metallic, such as steel; (2) non-metallic, which may be inorganic, such as glass; and (3) organic, such as wood or vegetable matter. In general, injuries caused by metal and glass are well-tolerated and, if they do not have any symptoms or signs, may be left in situ, whereas organic matter, such as wood and vegetable matter, is poorly tolerated, triggers an intense inflammatory. They require prompt and adequate management for salvaging the patients vision. This retrospective case report reviews the clinical features, appearance and management of four cases with intraorbital foreign bodies where the normal vision of the patient was retained

Retained Intra-orbital foreign bodies : A Short Case Series

ABSTRACT Intraorbital foreign in different forms are seen quite commonly in all age groups. These objects can be classified according to their compositionas (1) metallic, such as steel; (2) non-metallic, which may be inorganic, such as glass; and (3) organic, such as wood or vegetable matter. In general, injuries caused by metal and glass are well-tolerated and, if they do not have any symptoms or signs, may be left in situ, whereas organic matter, such as wood and vegetable matter, is poorly tolerated, triggers an intense inflammatory. They require prompt and adequate management for salvaging the patients vision. This retrospective case report reviews the clinical features, appearance and management of four cases with intraorbital foreign bodies where the normal vision of the patient was retained

FOREIGN BODY ORBIT

The aim of this case presentation was to present the troubles and significance of a proper diagnosis of a foreign body which was retained in the orbit. A 13 years old boy, had a wound on the infraorbital margin caused by a metal foreign body, which stayed in close to the orbit. X-ray and echographic examinations of the orbit were not conclusive regarding the question whether thisforeign body was situated within or outside the eyeball. Only CT imaging showed location of the foreign body. Foreign body was extracted by the same healed wound site.

Peri-orbital foreign body: a case report

<p>Abstract</p> <p>Introduction</p> <p>Foreign bodies inside the orbital cavity are rare. They can cause more or less serious complications, depending on their nature and size.</p> <p>Case presentation</p> <p>We report a case of a work-related accident involving a peri-orbital foreign body. The patient was a 50-year-old Caucasian man whose face was injured on the right side while he was working with an agricultural machine. On admission, he was fully conscious and did not have any neurological deficits. He had no loss of vision or ocular motility, but had a laceration of the lateral side of his right upper eyelid. A computed tomographic scan revealed a 6-cm-long bended metal object lodged in the lateral bulbar space of the right orbit. The patient recovered well after surgery and a course of antibiotic therapy.</p> <p>Conclusion</p> <p>The original aspects of this case are the singularity of the foreign body and its relative harmlessness in spite of its large size.</p

Review article – X Radiation dose implications in screening patients with ferromagnetic IOFBs prior to MRI: a literary review

Patients scheduled for a magnetic resonance imaging (MRI) scan sometimes require screening for ferromagnetic Intra Orbital Foreign Bodies (IOFBs). To assess this, they are required to fill out a screening protocol questionnaire before their scan. If it is established that a patient is at high risk, radiographic imaging is necessary. This review examines literature to evaluate which imaging modality should be used to screen for IOFBs, considering that the eye is highly sensitive to ionising radiation and any dose should be minimised. Method: Several websites and books were searched for information, these were as follows: PubMed, Science Direct, Web of Knowledge and Google Scholar. The terms searched related to IOFB, Ionising radiation, Magnetic Resonance Imaging Safety, Image Quality, Effective Dose, Orbits and X-ray. Thirty five articles were found, several were rejected due to age or irrelevance; twenty eight were eventually accepted. Results: There are several imaging techniques that can be used. Some articles investigated the use of ultrasound for investigation of ferromagnetic IOFBs of the eye and others discussed using Computed Tomography (CT) and X-ray. Some gaps in the literature were identified, mainly that there are no articles which discuss the lowest effective dose while having adequate image quality for orbital imaging. Conclusion: X-ray is the best method to identify IOFBs. The only problem is that there is no research which highlights exposure factors that maintain sufficient image quality for viewing IOFBs and keep the effective dose to the eye As Low As Reasonably Achievable (ALARA)

X Radiation dose implications in screening patients with ferromagnetic IOFBs prior to MRI: a literary review

Patients scheduled for a magnetic resonance imaging (MRI) scan sometimes require screening for ferromagnetic Intra Orbital Foreign Bodies (IOFBs). To assess this, they are required to fill out a screening protocol questionnaire before their scan. If it is established that a patient is at high risk, radiographic imaging is necessary. This review examines literature to evaluate which imaging modality should be used to screen for IOFBs, considering that the eye is highly sensitive to ionising radiation and any dose should be minimised. Method: Several websites and books were searched for information, these were as follows: PubMed, Science Direct, Web of Knowledge and Google Scholar. The terms searched related to IOFB, Ionising radiation, Magnetic Resonance Imaging Safety, Image Quality, Effective Dose, Orbits and X-ray. Thirty five articles were found, several were rejected due to age or irrelevance; twenty eight were eventually accepted. Results: There are several imaging techniques that can be used. Some articles investigated the use of ultrasound for investigation of ferromagnetic IOFBs of the eye and others discussed using Computed Tomography (CT) and X-ray. Some gaps in the literature were identified, mainly that there are no articles which discuss the lowest effective dose while having adequate image quality for orbital imaging. Conclusion: X-ray is the best method to identify IOFBs. The only problem is that there is no research which highlights exposure factors that maintain sufficient image quality for viewing IOFBs and keep the effective dose to the eye As Low As Reasonably Achievable (ALARA)

Computed tomography: ocular manifestations in acute head injury patients in Jos university teaching hospital

Background: Acute head injuries are common in the population. Associated ocular injuries are occasionally encountered and these are of varying nature and outcome.Methods: We reviewed 98 brain computed tomographic results retrospectively. These are cases that were done between Jan. 2013- Jan. 2014. Statistical information and analysis was performed using SPSS version 20. Pearson correlation was performed and the level of significance set at d=0.05. Student t-test was also performed to compare the difference of the ocular findings and sexes.Results: Head injuries are more in males with a ratio of 4:1. It was noted more in the third decade of life. Ocular findings were more in males and the severity of the ocular findings was related to the severity of the head injury.Keywords: Acute head injury, Ocular findings and Computed tomography

Preferred characterization of orbital infection (cellulitis) with exposure dose and relative medication

Background: A retrospective study presenting the endemic orbital infection (cellulitis) that breakout during dusty storm season; aiming to ascertain and showing the precedence of MRI for diagnosis of orbital infection rather than CT and revealing the diagnostic abilities of cross-sectional matrices spectrum.Methods: Based on retrospective collection of diagnostics (CT and MRI) information for randomly selected patients with cellulitis and the targeting the relevant data (image interpretation, exposure dose (DLP and CTDIvol), age, BMI and matrix cross-section spectrum findings).Results: The exposure dose of orbital CT exam was 59.4 (mGy) as CT dose index (CTDIvol) and 917.3 (mGy/cm) as dose length product (DLP) that increase by increment of age and BMI. The obese patients only exposed to dose exceeding the National Diagnostic Reference by 2.8%. MRI confirmed the inflammation around the optic nerve and extension to posterio-inferior portion of the globe and affecting the optic nerve with left sided proptosis (0.5cm) better than CT. The cross-sectional matrix successfully revealed that: the Lt optic nerve’s gray value (density) increases by a factor of 17.7 (a u) and enlarged by 5 pixels greater than the Rt optic nerve. Thickening, rough surface increased gray value by 30.5 (a u), muco-thickening and choncheal enlargement at the medial boarder of Lt orbit as 10.0 pixel and Lt eye ball enlarged by a factor of 10.9 pixels.Conclusions: MRI wisely diagnose orbital infection with more details and overcoming patient radiation exposure and usage of image spectrum gives detailed characterization of lesion morphology

Unique foreign body injury: bamboo penetration of thigh and pelvis while skiing

We present a case of traumatic bamboo foreign body penetration through the posterior thigh extending cephalad into the pelvis sustained during skiing. The unsuspected bamboo foreign body was missed prospectively on the initial portable trauma radiograph of the pelvis, but was retrospectively quite apparent as a linear 12×2-cm radiolucent region overlying the left pelvis and hip region. On CT examination, the bamboo stick appeared as a round cylindrical air-filled structure of high density compared to soft tissue – the typical appearance of bamboo. Bamboo foreign bodies can be recognized radiographically by this typical appearance, since it is one of the few wood products that causes high attenuation relative to soft tissue on CT.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/42350/1/s10140-002-0234-7.pd