A 2-YEAR-OLD boy fell from a second-floor balcony into a bush (Figure 1), and a branch lacerated the left upper eyelid and entered the orbit (Figure 2). Findings from computed tomography showed a radiolucent round object in the inferior orbit, with indentation and superior displacement of the globe (Figure 3). The object penetrated the infratemporal fossa via a fracture of the lateral wall (Figure 4). The entrance tract in the inferior fornix was explored (Figure 5). Multiple pieces of leaf and bark were removed and irrigated from the tract using antibiotic solution, the lid laceration was repaired, and a drain was placed (Figure 6). Findings from fundus examination showed only mild inferior commotio retinae. Intravenous cefuroxime sodium was administered for 1 week. With no signs of infection, he was given oral antibiotics and discharged from the hospital. Four years later, he had a visual acuity of 20/20 OU, full motility, and a well-healed eyelid.
Johnson TE. Intraorbital Branch. Arch Ophthalmol. 2000;118(4):590-591. doi:10.1001/archopht.118.4.590