Incidental finding of an orbital foreign body in a child with microcephaly and developmental delay.

A 3-year-old boy underwent investigations for microcephaly and global developmental delay. An MRI scan identified an ill-defined enhancing lesion in the left superolateral orbit. On subsequent questioning his parents reported that he had been admitted to a neighbouring hospital 2 months earlier with left-sided preseptal cellulitis following a fall onto a plastic toy. Following the episode of cellulitis he developed intermittent mild erythema and oedema of the left upper eyelid for which his parents had not sought further medical attention. The child was admitted for an anterior orbitotomy via a skin-crease approach that identified a large foam plastic foreign body. He made a good recovery from his surgery although he has had intermittent upper eyelid oedema attributed to a persistent granulomatous foreign body reaction. No underlying cause for his microcephaly and delayed development has yet been identified.