8/3/2019 Nearly an Eye-catcher

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www.thelancet.com  Vol 377 May 7, 2011 1599

Clinical Picture

Lancet 2011; 377: 1599

Published Online

April 21, 2011

DOI:10.1016/S0140-

6736(10)61118-X

Eye Clinic, Klinikum rechts

der Isar der Technischen

Universität München, Munich,

Germany (C Mayer MD,

R Khoramnia MD); Department

of Ophthalmology, University

of Heidelberg, Heidelberg,

Germany (R Khoramnia MD)

Correspondence to:

Dr Christian Mayer, Eye Clinic

Klinikum rechts der Isar der

Technischen Universität

München, Ismaninger Str 22,

81675 Munich, Germany

christian.mayer@lrz.

tu-muenchen.de

See Online for webvideo

Nearly an eye-catcher

Christian Mayer, Ramin Khoramnia

In June, 2008, a 15-year-old boy presented to ouremergency department with a key penetrating his leftorbit (figure A, B). He had been playing a game of football while wearing his key on a necklace. When ourpatient went to head the ball, his key flew upwardsagainst gravity, got in the way of the flight path of theapproaching football, and penetrated his left eye socket.CT showed that the key had lodged deep within theorbit, but fortunately it did not injure the globe

(figure C). Our patient had surgery to loosen andremove the key (webvideo), which had become lodgedin the inferior wall of the orbit (figure D). He was alsogiven prophylactic broad-spectrum antibiotics. Ourpatient recovered well after surgery and had no visualsequelae. He was in violation of FederationInternationale de Football Association (InternationalFederation of Association Football [FIFA]) rules bywearing a necklace with a key during the game.

Figure:Penetrating injury to the orbit

(A) and (B) show the key penetrating the left orbit (image taken at the time of prese ntation to our emergency department); (C) CT showing upward displacement of 

the globe. The key has penetrated the inferior wall of the orbit. The muscles, the optic nerve, and the globe are not affected; and (D) the foreign body. Scale in cm.

A C

B D