Missed Diagnosis of an Intraorbital Foreign Body of Homemade Fireworks Origin: A Case Report
Purpose: We report a rare case of traumatic injury to the eye caused by homemade fireworks in a Chinese juvenile patient with a metal ring left in the orbit after having been sutured at the Emergency Department. Methods: An 11-year-old boy presented with a traumatic injury to the right eye from home...
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| Format: | Article |
| Language: | English |
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Karger Publishers
2015-12-01
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| Series: | Case Reports in Ophthalmology |
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| Online Access: | http://www.karger.com/Article/FullText/442584 |
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| author | Dan-dan Zhou Kai Niu Cheng-wei Lu Ji-long Hao Bing-jie Zhang Peng Hui |
| author_facet | Dan-dan Zhou Kai Niu Cheng-wei Lu Ji-long Hao Bing-jie Zhang Peng Hui |
| author_sort | Dan-dan Zhou |
| collection | DOAJ |
| description | Purpose: We report a rare case of traumatic injury to the eye caused by homemade fireworks in a Chinese juvenile patient with a metal ring left in the orbit after having been sutured at the Emergency Department. Methods: An 11-year-old boy presented with a traumatic injury to the right eye from homemade fireworks. Following initial assessment involving maxillofacial computed tomography (CT) and suturing at the Emergency Department, he was transferred to our department for further evaluation because of his poor sight 1 day later. On examination, a skin laceration beneath the right eyebrow was noted, but the superior orbit was not fully visible on the maxillofacial CT performed 1 day previously. Therefore, an orbital CT scan was carried out on the second day, which showed a hyperdense ring embedded in the superior border of the orbital wall; the ring was surgically removed. On postoperative day 7, a fundus examination revealed resolving vitreous hemorrhage, blunt traumatic retinal detachment, and a large retinal tear superior to the macula. The patient refused to take surgery for retinal detachment into consideration. Therefore, we opted for oral steroids and careful observation. Results: After 2 months' observation, the large retinal tear had healed and white fibrous scar tissue had developed, and the retinal detachment superior to the macula had reattached itself spontaneously. The patient's vision had further improved to 20/200. During 1 year of follow-up, he remained clinically stable. Conclusion: To avoid missing the diagnosis, a complete history of the mechanism of injury and accurate imaging still prove most useful. Complete removal of the foreign body by the emergency physician is necessary because of the ocular toxicity of an iron-containing foreign body. As evidenced by the current case, oral steroids and observation for a period of several months is a management of choice for traumatic retinal detachment and retinal tear superior to the macula associated with homemade fireworks in children. |
| first_indexed | 2024-04-13T11:01:24Z |
| format | Article |
| id | doaj.art-9b3b86488a5044cdbc3ea4cb0f550a16 |
| institution | Directory Open Access Journal |
| issn | 1663-2699 |
| language | English |
| last_indexed | 2024-04-13T11:01:24Z |
| publishDate | 2015-12-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Case Reports in Ophthalmology |
| spelling | doaj.art-9b3b86488a5044cdbc3ea4cb0f550a162022-12-22T02:49:25ZengKarger PublishersCase Reports in Ophthalmology1663-26992015-12-016344845210.1159/000442584442584Missed Diagnosis of an Intraorbital Foreign Body of Homemade Fireworks Origin: A Case ReportDan-dan ZhouKai NiuCheng-wei LuJi-long HaoBing-jie ZhangPeng HuiPurpose: We report a rare case of traumatic injury to the eye caused by homemade fireworks in a Chinese juvenile patient with a metal ring left in the orbit after having been sutured at the Emergency Department. Methods: An 11-year-old boy presented with a traumatic injury to the right eye from homemade fireworks. Following initial assessment involving maxillofacial computed tomography (CT) and suturing at the Emergency Department, he was transferred to our department for further evaluation because of his poor sight 1 day later. On examination, a skin laceration beneath the right eyebrow was noted, but the superior orbit was not fully visible on the maxillofacial CT performed 1 day previously. Therefore, an orbital CT scan was carried out on the second day, which showed a hyperdense ring embedded in the superior border of the orbital wall; the ring was surgically removed. On postoperative day 7, a fundus examination revealed resolving vitreous hemorrhage, blunt traumatic retinal detachment, and a large retinal tear superior to the macula. The patient refused to take surgery for retinal detachment into consideration. Therefore, we opted for oral steroids and careful observation. Results: After 2 months' observation, the large retinal tear had healed and white fibrous scar tissue had developed, and the retinal detachment superior to the macula had reattached itself spontaneously. The patient's vision had further improved to 20/200. During 1 year of follow-up, he remained clinically stable. Conclusion: To avoid missing the diagnosis, a complete history of the mechanism of injury and accurate imaging still prove most useful. Complete removal of the foreign body by the emergency physician is necessary because of the ocular toxicity of an iron-containing foreign body. As evidenced by the current case, oral steroids and observation for a period of several months is a management of choice for traumatic retinal detachment and retinal tear superior to the macula associated with homemade fireworks in children.http://www.karger.com/Article/FullText/442584Homemade fireworksMaxillofacial and orbital traumaRetinal detachmentOrbital foreign body |
| spellingShingle | Dan-dan Zhou Kai Niu Cheng-wei Lu Ji-long Hao Bing-jie Zhang Peng Hui Missed Diagnosis of an Intraorbital Foreign Body of Homemade Fireworks Origin: A Case Report Case Reports in Ophthalmology Homemade fireworks Maxillofacial and orbital trauma Retinal detachment Orbital foreign body |
| title | Missed Diagnosis of an Intraorbital Foreign Body of Homemade Fireworks Origin: A Case Report |
| title_full | Missed Diagnosis of an Intraorbital Foreign Body of Homemade Fireworks Origin: A Case Report |
| title_fullStr | Missed Diagnosis of an Intraorbital Foreign Body of Homemade Fireworks Origin: A Case Report |
| title_full_unstemmed | Missed Diagnosis of an Intraorbital Foreign Body of Homemade Fireworks Origin: A Case Report |
| title_short | Missed Diagnosis of an Intraorbital Foreign Body of Homemade Fireworks Origin: A Case Report |
| title_sort | missed diagnosis of an intraorbital foreign body of homemade fireworks origin a case report |
| topic | Homemade fireworks Maxillofacial and orbital trauma Retinal detachment Orbital foreign body |
| url | http://www.karger.com/Article/FullText/442584 |
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