Orbital foreign bodies: expect the unexpected.

Data of three pediatric patients with orbitofacial trauma were reviewed. Two patients presented with recurrent orbital inflammation with partial remission with antibiotics. One patient presented with diplopia. All patients underwent full opthalmic examination and computed tomography (CT) of the brain and orbit, followed by surgical intervention. The indication for surgery was either abscess evacuation, repair of blowout fracture, or mass excision. All of the patients had intraorbital wood foreign bodies that were not evident on CT and were not suspected from the history given by the parents. All were surgically removed. One patient had multiple wood foreign bodies (more than 10). Chronic or recurrent orbital inflammation, unexplained proptosis, or orbital masses following orbitofacial trauma in children should raise the suspicion of intraorbital foreign bodies even if not detected by CT studies. Presence of other sequelae of trauma such as blowout fracture does not exclude the possibility of associated foreign bodies.