Orbital impalement injury. An unusual case.

A 24-year-old man suffered an orbital impalement injury from a car aerial antenna that penetrated the medial third of the right lower lid. Immediately after the accident a convergent eye position, diplopia, and complete paresis of the upper lid as well as reduced abduction could be observed; the uninjured globe could not be moved beyond the midline. According to orbital tomograms and a traction test an incarceration of the medial rectus muscle was suspected. Electromyography 24 days after the accident revealed a peripheral paresis of the abducens nerve but an intact medial rectus muscle. Surgical exploration of the muscle was postponed, and the condition of the eye gradually improved; 8 days after the electromyography the clinical examination as well as the electromyogram showed near to normal results.