Successful management of a rare intraorbital wooden foreign body extending to the orbital apex in a paediatric patient

Intraorbital foreign bodies (IOFBs) are a recognised complication of orbital trauma, but intraorbital wooden foreign bodies are rare and pose significant diagnostic and management challenges due to their radiolucency, high risk of infection and potential for severe inflammation. This case describes a rare presentation of a young boy who sustained orbital trauma after an 8-foot fall, resulting in a 5 cm x 3 cm wooden IOFB extending to the orbital apex with an associated sphenoid fracture. He presented with proptosis, an inferotemporal scleral indentation mimicking retinal detachment and a lateral infraorbital laceration. CT imaging confirmed the diagnosis, and timely surgical removal via an extended infraorbital approach, along with broad-spectrum antimicrobial therapy, led to visual recovery and resolution of proptosis. This case highlights the importance of early diagnosis, individualised surgical planning and a multidisciplinary approach in managing paediatric orbital trauma caused by organic foreign bodies.