A minor lid laceration concealing a potentially life-threatening injury.
A 29-year-man presented with an injury to his left upper lid, having stumbled onto the tip of a pool cue. He presented with minimal signs and symptoms, initially thought as a minor lid laceration and was managed with lid suturing. Two months later, he presented with vertical diplopia on upward gaze and showed a picture consistent with traumatic Brown's syndrome. Subsequent imaging revealed the extent of orbital injury and confirmed a retained foreign body embedded in the frontal lobe of the brain. This was surgically removed and found to represent the tip of the pool cue. Postoperatively, the patient made a good recovery, although he still has a slight residual diplopia on upward gaze.
Ophthalmology Department, Harrogate District Hospital, Harrogate, UK. lamisabdelaziz@doctors.org.uk
Lamis
L
Abdelaziz
Ramez
R
Barbara
David
D
Scullion
Edel
E
Cosgrave
Timothy
T
Metcalfe
D000328:Adult; D001930:Brain Injuries / Q000150:complications* / Q000175:diagnosis; D003937:Diagnosis, Differential; D004172:Diplopia / Q000175:diagnosis / Q000209:etiology*; D005131:Eye Injuries / Q000150:complications* / Q000175:diagnosis; D005143:Eyelids / Q000293:injuries*; D005547:Foreign Bodies / Q000150:complications* / Q000175:diagnosis; D005625:Frontal Lobe / Q000293:injuries*; D006801:Humans; D022125:Lacerations / Q000150:complications* / Q000175:diagnosis; D008279:Magnetic Resonance Imaging; D008297:Male; D014057:Tomography, X-Ray Computed