Surgical Extraction of Traumatic Lodgment of a Pen Nib Between the Eye and Nasal Bridge of an Infant: A Case Report

Unintentional eye injuries are common in small children. If left unobserved by parents or caretakers, it is challenging to assess as the kids are in distress and pain. Penetrating trauma in or near the eye requires urgent treatment as it can lead to infection and other complications. Early diagnosis and management help avoid further complications. An 11-month-old female was presented by her parents at a tertiary care clinic with inconsolable crying and swelling over the right eye's upper lid for one day. There was a history of possible trauma with a pen while the child was playing. During the examination, swelling in the right periorbital region between the eye and nasal bridge with the opening of the foreign body tract was noted. A skull X-ray with orbit showed a radiopaque nib of the pen in the right periorbital soft tissue. Emergency surgery was planned under general anesthesia. Surgery was performed and the pen was extracted from the right periorbital soft tissue lying between the eye and nasal bridge. Parents and health care providers, including pediatricians, should assess a crying child with a trauma history carefully even with no apparent clinical findings. Efforts must be done to correlate clinical findings with proper history and other needed investigations.