Pen in the eye

There are certain things you like and certain things not so much. I dig just about anything trauma related. But eye trauma is one of those things that I just find sort of creepy. Well, in a recent trauma lecture we had a great Head & Neck surgeon come and talk about facial trauma...which of course included eyes. It was great to learn the nitty gritty of Le Forte fractures, which we see quite often in facial fractures, but the orbital trauma makes me want to squirm.

Apparently jail inmates place an empty pen shell over a real pen. So what this means is when they stab someone, they pull the pen out and everyone thinks that what went in came out, but really the pen shell got pulled off and left behind. This matters anywhere a person is stabbed, really. But we saw video of a this being next to the eye. A patient stabbed to the eye complained of pain to the eye and initial providers sewed the lac without further imaging. There was some mild edema near the medial canthus, however no overt signs of a large foreign body. Yet once transferred, further imaging revealed a large portion of a pen, which was subsequently removed surgically.

It was quite interesting seeing howing eye trauma, and facial fractures, are repaired. An incision is made on the inside of the lower lid until the bone underneath is accessed. And then that opens a whole eyeball world. The topic was interesting and enlightening, although it still makes me squirm.