A trans-orbital pencil in the left carotid artery of a 40-year-old man: clinical and radiographic images

Orbital Penetrating Injuries: A Review on Evaluation and Management

“…Numerous case reports exist in the literature that describe unusual foreign bodies that have been involved in nonmissile penetrating orbital injuries, some of which caused intracranially injuries as well. Such foreign bodies include eating utensils (fork, 19,20 knife, 10,21 barbeque skewer, 10 chopstick 22–24 ), writing utensils (pen, 2,25,26 pencil, 14,27–34 scissors, 35 paintbrush 36 ), construction tools (nail, 10,37 screwdriver, 10 industrial hook 2 ), vegetative material (tree branch, 38,39 fern, 40 bamboo 41 ), household items (umbrella, 42 eyeglasses earpiece, 43–45 toilet brush handle, 46 toothbrush,[ 47 ]door key, 48 metal shelving bar, 12,22,49 knitting needle 50 ), and other miscellaneous objects (windshield wiper, 2,13 spear gun, 10 fishing hook, 10 needlefish, 51–56 kangaroo tooth, 57 and bicycle handlebar 2,58 ).…”

“…Case reports of penetrating orbital injuries demonstrate a wide range of long-term sequelae after injury depending on the affected structures. Neuro-ophthalmic complications include vision loss, motility limitations, or ophthalmoplegia due to cranial neuropathies, 17,18,27 seventh nerve palsies, 50 and one-and-a-half syndrome (e.g., left conjugate horizontal gaze palsy and left internuclear ophthalmoplegia from left pons trauma) 77 . One case report described delayed (3 days after injury) herniation of intracranial contents into the orbit in a child through an orbital roof fracture defect causing severe exophthalmos and vision loss 58 .…”