Missed diagnosis of a wooden intra-orbital foreign body

Intraorbital foreign bodies often present a confusing clinical picture. Wooden foreign bodies are notorious for remaining quiescent for a long time, before presenting with a variety of complications. The wound of entry may often be small and self-sealing. Wooden foreign bodies also show a propensity to break during attempted removal. Intraorbital wood is often not detected by standard diagnostic tests like the computed tomography scan, adding to the diagnostic dilemma. The presence of an intraorbital mass with a discharging sinus should evoke suspicion of a retained organic foreign body, regardless of the time interval between the trauma and current presentation. It is imperative to maintain a high index of suspicion in such cases to avoid misdiagnosis. We report an unusual case of a missed wooden intraorbital foreign body, which spontaneously extruded after five years.