Orbital damage due to falling screw

A 33-year-old male presented to a community hospital for vision loss in his left eye after a screw fell from a height of approximately 12 inches onto his eye. The patient complained of mild to moderate pain and was able to see only bright lights and shadows. Physical examination noted fluorescein uptake over the central cornea without a definite Seidel sign present. Pupils were equal, round, and reactive to light. Extraocular movements were painful on examination. Surrounding structures, such as the eyelids, were uninjured. The patient was transferred to a tertiary care center for ophthalmology evaluation for concerns of a ruptured globe. A computed tomography (CT) scan of the orbits was performed prior to transfer and showed a small left periorbital laceration (Figure 1). Ophthalmology evaluation showed a full thickness corneal laceration and traumatic cataract, which were repaired in the operating room. Moxifloxacin, timoptic, prednisolone topical, and cyclogel were started and the patient was discharged with outpatient follow-up (Figures 2 and 3).

The authors declare they have no conflicts of interest.