title: Remote penetrating orbital trauma due to a snooker cue through the mouth.
abstract: OBJECTIVE
  This is a unique case report of a self-inflicted orbital injury that presented as a simple upper vestibulum laceration. A 43-year-old man presented to the Oral and Maxillofacial Surgery Unit with a small laceration in his mouth and complaints of pain in his left eye due to a snooker cue penetration. Upon admission, clinical findings included a small laceration on the upper left vestibulum and a subdermal hematoma in the left eye lid with restricted movements of the left eye. Further examination revealed remote trauma to the orbit, penetrating through the oral cavity, passing the maxillary sinus, and the orbital floor causing traumatic optic neuropathy with partial visual loss. The patient was treated conservatively with antibiotics and corticosteroids and a 6-week follow up.
  
  
  CONCLUSIONS
  In cases of remote penetrating injury, meticulous examination revealing precise injury mechanism is crucial. All cases of Dento-maxillofacial trauma should include a high degree of clinical suspicion for ocular injury, requiring early diagnosis and treatment to reduce risk of visual loss.
authors.affiliation: Oral and Maxillofacial Surgery Unit, Ziv Medical Center, Safed, Israel. alex.r@ziv.health.gov.il
authors.forename: Alejandro
authors.initials: A
authors.lastname: Roisentul
authors.forename: Peter
authors.initials: P
authors.lastname: Gilbey
authors.forename: Joseph
authors.initials: J
authors.lastname: Pikkel
mesh_terms: D000328:Adult; D005143:Eyelids / Q000293:injuries; D005500:Follow-Up Studies; D005547:Foreign Bodies / Q000150:complications*; D006406:Hematoma / Q000209:etiology; D006801:Humans; D022125:Lacerations / Q000209:etiology; D008297:Male; D008443:Maxillary Sinus / Q000293:injuries; D009055:Mouth / Q000293:injuries*; D020221:Optic Nerve Injuries / Q000209:etiology; D009917:Orbital Fractures / Q000209:etiology*; D012887:Skull Fractures / Q000209:etiology; D014786:Vision Disorders / Q000209:etiology; D014792:Visual Acuity / Q000502:physiology; D014950:Wounds, Penetrating / Q000209:etiology*