Retained intraorbital wooden foreign body presenting with combined anterior and posterior scleritis.

Penetrating injury of the orbit with a wooden stick is not an uncommon finding in ocular emergencies. A 36-year-old man presented with redness, pain in the left eye following fall from a motorcycle 3 days ago. Ocular examination showed features of combined anterior and posterior scleritis in the form of an anterior scleral nodule, retinal folds and T sign on ultrasonography. There was worsening of symptoms along with new onset diplopia following scleral deroofing which led to the suspicion of an intraorbital wooden foreign body (IOWFB). CT scan of orbit showed a well-defined hypodensity between the medial rectus and optic nerve resembling a pocket of air surrounded by a rim of hyperdensity. IOWFB was removed under direct visualisation via transconjunctival orbitotomy. This is the case of a missed retained IOWFB presenting with features of combined anterior and posterior scleritis. © BMJ Publishing Group Limited 2020. No commercial re-use. See rights and permissions. Published by BMJ.