C A S E / Wooden intraorbital foreign body

Discussion

Intraorbital foreign bodies are not uncommon

but have been reported more frequently in
dogs than in cats.1 Organic foreign bodies
mainly consist of migrating grass awns,1–3
although wooden materials and porcupine
quills have also been encountered.4 In the
present case, the foreign body appeared to be
a splinter of dead wood (Fig 2), possibly from
a wooden box, plank, railing or item of old
furniture.
Orbital (including intraocular) foreign bodies,
have been reported to have a poor prognosis.2 FIG 3 The cat 3 months
They are commonly associated with cellulitis postoperatively
and orbital abscessation, culminating in the
need for enucleation.2,5 Moreover, plant and
wooden materials may carry soil-borne bacteria References
or fungi that can potentially cause panoph-
thalmitis.5 Migration of an organic foreign body 1 Brennan KE, Ihrke PJ. Grass awn migration in dogs and cats: a retrospective
may also lead to ocular penetration and severe study of 182 cases. J Am Vet Med Assoc 1983; 182: 1201–4.
lesions.2 There is a report of non-specific injury 2 Tovar MC, Huguet E, Gomezi MA. Orbital cellulitis and intraocular abscess
to the central nervous system of a man associat- caused by a migrating grass in a cat. Vet Ophthalmol 2005; 8: 353–56.
ed with a retained wooden golf tee.5 3 Bussanich MN, Rootman J. Intraocular foreign body in a dog. Can Vet J 1981; 22:
The present report details an exceptional 207–10.
case of a wooden foreign body in the orbit of 4 Grahn BH, Szentimrey D, Pharr JW, Farrow CS, Fowler D. Ocular and orbital
a cat – unusual in terms of its dimensions and porcupine quills in the dog: a review and case series. Can Vet J 1995; 36: 488–93.
the relative absence of inflammatory reaction 5 Specht CS, Varga JH, Jalali MM, Edelstein JP. Orbito cranial wooden foreign body
and infection in the host over a prolonged diagnosed by magnetic resonance imaging. Dry wood can be isodense with air
period of time. A similar case has been report- and orbital fat by computed tomography. Surv Ophthalmol 1992; 36: 341–44.
ed in a 46-year-old man with a retained orbital 6 Macrae JA. Diagnosis and management of a wooden orbital foreign body: case
wooden twig, which remained undetected for report. Br J Ophthalmol 1979; 63: 848–51.
14 weeks.6 Such a presentation emphasises the 7 Green BF, Kraft SP, Carter KD, Buncic JR, Nerad JA, Armstrong D. Intraorbital
need to include a possible retained foreign wood. Detection by magnetic resonance imaging. Ophthalmology 1990; 97: 608–11.
body in the differential diagnosis of cats with 8 Ossoinig KC (1991) Detection of wood foreign bodies. Ophthalmology 1991; 98:
conjunctivitis, especially when a conjunctival 274–75.
laceration is detected.6 9 Dennis R. Use of magnetic resonance imaging for the investigation of orbital
The difficulty of diagnosing a wooden for- disease in small animals. J Small Anim Pract 2000; 41: 145–55.
eign body retained inside the orbit or cranium
has been much discussed.5–8 In the present
clinical case, orbital ultrasonography was Such a presentation emphasises the need
clearly suggestive of a retained foreign body.
Ultrasonography has indeed proven to be to include a possible retained foreign body
effective in detecting a range of organic for-
eign bodies,9 but has not been successful in all in the differential diagnosis of cats with
cases.2 An additional CT scan was decisive in
this case, both confirming the presence of a conjunctivitis, especially when a conjunctival
foreign body and determining its dimensions
and exact location prior to surgery. laceration is detected.

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