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Penetrating orbital trauma by stiletto causing complex cranial neuropathies
  1. G Cleary1,
  2. K K Nischal2,
  3. C A Jones1
  1. 1Maidstone Hospital, Maidstone, UK
  2. 2Great Ormond Street Hospital for Children, London, UK
  1. Correspondence to:
 Dr G Cleary
 Ear, Eye and Mouth Unit, Maidstone Hospital, Hermitage Lane, Barming, Maidstone, Kent ME16 9QQ, UK; geocle01{at}


Penetrating orbital injuries pose a serious threat to vision, ocular motility, and in some cases, life. Long, sharp stiletto objects may penetrate deeply, causing catastrophic damage to orbital structures, despite seemingly trivial entry wounds. The authors present two cases of penetrating orbital injuries by stiletto objects, both entering via small eyelid wounds. Traumatic optic neuropathy occurred in both cases, and was treated with corticosteroids, however the globes escaped direct injury. Injuries to the IIIrd and VIth cranial nerves were also observed. Deep orbital injuries must be excluded in patients presenting with small eyelid wounds caused by sharp penetrating objects.

  • penetrating orbital injuries
  • optic nerve injuries
  • cranial nerve injuries

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  • Competing interests: none declared