Raikar Dylan G, Winkler Kathryn P
Rush Medical College, USA.
Department of Ophthalmology, Section of Oculoplastic Surgery, Rush University Medical Center, USA.
Am J Ophthalmol Case Rep. 2024 Jul 5;36:102093. doi: 10.1016/j.ajoc.2024.102093. eCollection 2024 Dec.
The diagnosis of retained intraorbital organic foreign body can pose significant challenges without corroboration from a detailed patient history even when presented with clear and accurate imaging.
We present a case of a 65-year-old woman with an upper lid lesion that she noticed 1.5 years ago which subsequently became inflamed four weeks before evaluation. A one cm-long green plant stem was removed from a superior orbital tract, leading to symptom resolution. The patient recalled a fall three years prior, during which the initial embedding occurred. Following the fall, she experienced binocular diplopia for two months which spontaneously resolved.
We believe this is one of the first cases of a retained intraorbital organic foreign body that initially presented with symptoms, resolved, and subsequently presented years later with different symptoms, leading to the discovery of the foreign body. This case serves as an important reminder to physicians that retained organic foreign bodies can have long quiescent periods and delayed clinical presentations.
即使有清晰准确的影像学检查结果，若没有详细的患者病史佐证，眶内有机异物残留的诊断仍可能面临重大挑战。
我们报告一例65岁女性病例，她1.5年前发现上睑有一病变，在评估前四周该病变出现炎症。从眶上管取出一根1厘米长的绿色植物茎，症状得以缓解。患者回忆起三年前曾摔倒，最初异物就是在那时嵌入的。摔倒后，她双眼复视了两个月，之后自行缓解。
我们认为这是首例眶内有机异物残留病例，最初有症状，之后缓解，多年后又出现不同症状，最终发现异物。该病例提醒医生，有机异物残留可能有很长的静止期和延迟的临床表现。
