Management of Combined Penetrating Intraorbital and Intracranial Trauma

Penetrating orbitocranial trauma is fortunately an uncommon type of injury. 1,2 Intracranial extension of a foreign body can damage vascular and neural structures. Close cooperation between ophthalmologists and neurosurgeons is essential to maximize visual potential and minimize the risk of devastating neurologic complications. We report an unusual case of penetrating orbital injury with a foreign body extending deeply into the cranium. Report of a Case. —An 11-year-old boy presented with a penetrating orbital injury. While playing with a sled, a cord fabricated to pull it consisting of a length of rubber tubing ensheathing a shorter segment of steel rod gave way after a vigorous tug and was thrust into the right orbit. On examination a 5-cm portion of metal rod covered with rubber tubing was protruding from the area of the right medial canthus (Fig 1). Visual acuity was 20/200 OD with an 8-mm pupil with minimal light reactivity; however,