Emergency casebook
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A 22 year old male involved in a road rage incident presented to the casualty department with a painful left eye. On examination, glass fragments were found in the left conjunctival fornix, with an inferior left corneal laceration. Plain radiography showed a radio-opaque area in the left orbital area, and the suspicion of an intraorbital foreign body was raised. Further clinical and radiological investigation demonstrated the area thought to be a foreign body was in fact an anatomical variant of the foramina of the orbit, known as the ophthalmo-meningeal foramen. It is also known as the lacrimal foramen, the meningeal foramen, or the foramen meningeo-orbitale. This case served as a useful reminder of the relative importance of clinical findings when making a diagnosis, as well as reminding us that knowledge of the normal appearance, as well as possible anatomical variants, is required to avoid confusion when interpreting the results of
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