Copyright @ 200 Mutaz B. Habal, MD. Unauthorized reproduction of this article is prohibited. 8 Orbital Foreign Body Penetrating From the Cheek Ozgur Akdogan, MD,* Ibrahim Ozcan, MD,* Adin Selcuk, MD,* Nagihan Bilal, MD,* Sinan Saricao?lu, MD, 1 Serdar Ensari, MD, Assoc Prof* Ankara, Turkey This study emphasizes the importance of diagnos- tic first aid procedures to avoid the consequences of trauma due to foreign body. A 20-year-old man referred to our hospital with a history of having a sharp penetrating injury to his right eye. Computed tomography evaluation reported right globe per- foration and intraorbital glass foreign body mea- suring 4 Â 7 cm was removed. Perforated eye was repaired and traumatic cuts were sutured. Orbital and ocular injuries are common, and delays in management may lead to complication. A team approach is the best technique for these patients. Key Words: Foreign body, ocular injury, trauma P atients with eye problems are likely to make up a significant proportion of those seen in the emergency department. Retained orbital foreign bodies (FB) are not rare and are usually related high velocity injuries to the orbit. 1,2 The FB may be composed of metal, glass, wood, and other organic materials. Computed tomographic (CT) scanning is the best imaging procedure for identification and localization of FB. 3 We report a case of orbital trauma with a glass measuring 4 Â 7 cm that penetrates from the anterior wall of the maxillary sinus. CASE REPORT A 20-year-old man referred to our hospital with a history of having a sharp penetrating injury to his right eye. The accident was the patients’ fault of going through a glass door. There was 7-cm skin incision on the anterior wall of the maxillary sinus on the cheek. Examination of the eye revealed fixed and dilated pupils, absent mobility, lid edema and proptosis, and total retinal detachment and no penetration side for orbital FB. CT evaluation reported right globe perforation and intraorbital glass FB measuring 4 Â 7 cm (Fig 1). Under general anesthesia, the orbital floor was exposed after careful dissection, glass FB was seen and was dexterously removed, and entry track was explored and irrigated, retrieving 4 smaller fragments (Fig 2). The grade of globe injury was 4 and type E. Perforated eye was repaired and traumatic cuts were sutured. The patient received intravenous ampicillin-sulbactam 1000 mg 3 Â 1 postoperatively. At 6 months after the injury, there was no visual acuity. DISCUSSIONS P enetrating ocular injury due to an intraorbital foreign is a common incident in an ophthalmo- logic practice. This type of injury usually leads to severe visual loss. Surgery to remove orbital foreign Fig 1 CT scan showing the foreign body penetrating the globe. 439 From the *Ankara Numune Education and Research Hospital, 4th ENT Clinic; and 1 Ankara Numune Education and Research Hospita l, 3rd Eye Clinic, Ankara, Turkey. Address correspondence and reprint requests to Ozgur Akdogan, Boncuk Sok. 14/8 Kurtuluz, Ankara, Turkey; E-mail: drozgurakdogan@gmail.com