Инородное тело орбиты у ребенка школьного возраста (клинический случай)

Abstract

The article presents a clinical case of May 2020. An 11-year old girl turned to the admission department of the regional children’s hospital with a suspected eyelid abscess. The day before she was seen by an ophthalmologist, parents refused from suggested abscess opening. According to anamnesis data, the girl got a strike in the upper eyelid of the right eye with a pen from herself at home. The girl and her parents could not tell exactly what was the pen like and was it whole after the strike or not. Initially an upper eyelid abscess of the right eye was diagnosed. During examination an eyelid wound, exotropia and limited adduction on the affected side, pronounced diplopia were found. Previously, the child was healthy.Anti-inflammatory, antibacterial therapy was prescribed. According to orbital computer tomography, tissue swelling, and gas accumulation were found in the right orbit. After three days of antibacterial therapy exotropia and diplopia have decreased. Limitation of the right eye adduction persisted. Wound revision with metal probe was performed which revealed a foreign body deep in the orbit. The foreign body had a limited approach, its exact location and dimensions were unknown. The girl underwent MRI of the orbits. A foreign body in the right orbit which was a ballpoint pen cap located between the medial wall of the orbit and medial rectus muscle was. An operation was performed. Eyelid wound was enlarged, and a foreign body was removed which was a cap and corpus fragments of a ballpoint pen. During the following rehabilitation period, diplopia and exophoria have completely disappeared, eyeball mobility was restored, and the girl was discharged after recovery. Diagnostics was difficult due to lack of anamnesis data; search of the foreign body was also difficult because plastic is an found X-ray negative material. Key words: orbital trauma; foreign body.