Organic Foreign Body in the Eye, a Diagnostic Challenge: A Case of a Wooden, Intra-orbital Foreign Body Presenting at the Emergency Department

Intra-orbital organic foreign body injuries occur within the eye but without the involvement of the orbit itself. A 39-year-old man self-presented to the emergency department complaining of sudden onset of pain surrounding his left eye and of reduced vision. The initial examination was unremarkable except for two healing lesion marks above his left upper eyelid. Some swelling with erythematous skin changes was also noted. Computer tomography did not identify a conclusive cause. The patient was assessed by an Ophthalmologist in Eye Casualty and commenced intravenous antibiotics for infection secondary to an intra-orbital wooden foreign body. The patient underwent surgery to remove the foreign body, experienced no postoperative complications, and was discharged following a brief medical admission for intravenous antibiotic administration, with vision returning to normal in the affected eye. This case report showcases the difficulty of such cases, given the organic nature of the foreign body. It also highlights the need for high clinical suspicion with thorough history-taking, as well as physician collaboration, to ensure organic foreign bodies are considered in similar presentations or cases.