Purpose: Report a case of foreign body:

• A branch of eucalyptus tree is perforated into the lower eyelid, next to the globe caused orbital abscess and diplopia. This case was diagnosed and was operated for removing of the foreign body on day 24th after onset.

Design: Case Report of clinical diagnosis and intervention.

Main measures: clinical signs, paraclinical signs included: • X-ray: no sign is detected as twigs did not opacity in X-ray. • Ultrasound: showed foreign body in the orbit, but does not specify the shape, the size of the object and patient’s history.

Diagnosis:  Foreign body into the orbit through lower lid caused abscess and diplopia

Interventions: surgery and results:

Foreign body into the orbit through lower lid

On day 24th since foreign body in the eye: Local anesthesia and conjunctiva. Surgical exploration through wounded traces extending along the outer eyeball, in positions 3-4 o’ clock, freeing abscess pus was done. After pus cleaning, strabismus hook was used for detecting foreign body that is located directly beneath the lower rectus muscle, stabbed in the globe and orbit. Then the foreign body was extracted by strabismus hook. Foreign objects is a twigs tree with size: 5mm diameter, 20mm length. One week after surgery: the abscess collapse, less conjunctiva hyperemia, less bruising lid, no diplopia. Three weeks after the removal of foreign right eye completely back to normal, vision 1/10, IOP 17mmHg.

Conclusion:

1. The initial management and closely monitor patients every day has an important role to remove the foreign bodies as soon as possible, to minimize complications contribute to the success of treatment.

2. Patients with complications and delay in hospital admission and whether did not find any foreign bodies or not:

• Careful detail history patient: especially object is small sized such as twigs of tree.

• Combining the clinical signs: deeply abscess orbit, using strong pressing on the wound to detect the pus out hyperemia of conjunctivitis, diplopia, ptosis and signs of subclinical: ultrasound, X-rays, CT are very useful.

3. Perform surgery for abcess debridment as well as detect foreign body helping remove foreign bodies sooner with results expected.