Workup
Laboratory Studies
Document drug screen and blood alcohol level when appropriate. If a risk for HIV or hepatitis transmission is present, perform baseline serology.
Next:
Imaging Studies
CT scan may confirm or reveal foreign bodies, a retrobulbar hemorrhage, a globe rupture, or an orbital fracture.
Depending on the size and lead content, glass foreign bodies may or may not be seen on radiography.
Orbital wood foreign bodies can be difficult to detect but may appear isodense with orbital fat. If no metallic foreign body is present and yet orbital wood is suspected but not seen on CT scan, an orbital MRI should be obtained. [5]
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Media Gallery
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Extramarginal upper lid laceration from blunt trauma in an infant. Such lacerations tend to follow relaxed skin tension lines.
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Penetrating lid trauma with extensive periorbital ecchymosis. A ringlike projectile was ejected from a pipe fitting under high pressure. The patient also experienced choroidal rupture and traumatic optic neuropathy.
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Preoperative. This child had a dog bite injury with a double lower lid margin laceration, dehiscence of the lateral canthal tendon, and disruption of the inferior canaliculus.
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Postoperative. The inferior canaliculus was repaired with bicanalicular stenting. Lateral canthus reattachment and repair of lid margin lacerations was performed.
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