Orbital foreign body: stiletto shoe

Case contributed by Jayanth Keshavamurthy
Diagnosis certain

Presentation

Shoe lodged in left eye socket.

Patient Data

Age: 20 years
Gender: Female

CT scouts

x-ray

Scout view shows a stiletto shoe through the orbit. 

  • left infraorbital canal/orbital floor and posterior wall of the left maxillary sinus fractures along with left maxillary hemosinus due to embedded high heel containing metal rod through the left orbit inferior nasal quadrant
  • optic nerve as well as superior and medial rectus muscles appear intact
  • due to extensive streak artifact it is difficult to assess for globe, as well as inferior and lateral rectus injury

Case Discussion

The stiletto was manually removed under general anesthesia (see reference below for description).

Repeat CT impression:

Interval removal of foreign body from the left orbit with orbital fractures as described before. Ocular globes, extraocular muscles, and optic nerves appear grossly intact.

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