A rare case in a dog of intraorbital foreign body with late signs of cornea penetration - presenting initially as anterior uveitis

Abstract

An unusual case is presented of an unsuspected orbital metallic foreign body (sewing needle) in a dog. The skin entrance wound injury was undetected during two clinical examinations, likely due to the quick skin healing and punctiform nature of the wound in the skin/muscles/orbit. The most unusual characteristic of this case is the cause of the wound. The metallic foreign body could have penetrated the cornea through an oblique limbal/scleral pathway at the moment of injury, leaving no obvious signs of corneal injury in the first clinical examination. Secondly, the corneal injury perhaps occurred due to the dog rubbing its head on the floor between the initial examination and the first follow-up examination after seven days. At first, the case presented as anterior uveitis with an unknown cause. Due to quick scar formation of wounds in dogs and the fact that punctiform wounds can be difficult to detect, an orbital foreign body was not initially suspected. However, seven days afterwards, a new sign of triangular limbus-based corneal opacification appeared. This led to suspicion of a previous corneal injury and the nearby (orbital) presence of a foreign body. This diagnosis was confirmed by radiography and the intraorbital sewing needle was extracted by surgery. Lack of sophisticated techniques did not prevent an adequate diagnosis and an excellent surgical outcome.

Neobičan slučaj neočekivanog metalnog stranog tela u orbiti psa, prisutnog kao posledica punktiformne povrede na koži iglom koja nije uočena usled brzog zarastanja i kretanja kroz kožu, mišiće i orbitu. Najneobičnija karakteristika ovog slučaja je strano telo (šivaća igla) koje je penetriralo rožnjaču prolazeći kroz limbus i beonjaču pod kosim uglom, a u momentu povređivanja, kao i na prvom pregledu nije bilo znakova koji bi ukazivali na to ili je povreda rožnjače nastala češanjem glave o pod između prvog i drugog pregleda u razmaku od sedam dana. Na početku, slučaj je izgledao kao anteriorni uveitis nepoznatog uzroka i sedam dana kasnije se pojavilo trouglasto zamućenje rožnjače sa bazom prema limbusu što nas je dovelo u sumnju da je prethodna povreda rožnjače povezana sa orbitalnim stranim telom. Usled brzog zarastanja rana i formiranja ožiljka kod pasa i nedovoljno jasnih kliničkih znakova punktiformnih rana orbitalno strano telo nije bilo očekivano. Penetrantna rana na rožnjači je mogla nastati pre prvog pregleda ili u vremenu između prvog i drugog pregleda trljanjem glave. Nedostatak sofisticirane tehnike ne sprečava postavljanje tačne dijagnoze i primene adekvatne hirurgije.