One of the surgeries I deal with is removal of foreign bodies within the orbit. For example, this can happen from BB bullet or a shard of glass being lodged into in the orbit but miraculously sparing the eyeball. In certain cases such foreign bodies need to be removed. The surgery needs to be carefully planned so as to protect the eye and the surrounding structures (such as the eye muscles, optic nerve, blood vessels, and other nerves).
One patient recently showed up with a BB bullet lodged under her eyeball. See the photos below. It was causing double vision and swelling around her eye. She underwent an orbital surgery to carefully remove the BB bullet.
CT scans showing the foreign body above the orbital floor and below the eyeball.
Intraoperative photo showing the BB bullet being retreived from the orbit after succesfull orbital exploration.
A couple of my colleagues and I published a paper on the management of orbital foreign bodies several years ago which shows an interesting working paradigm on their management. Click here to download the manuscript. Open Reconstructive and Cosmetic Surgery, 2008, 1, 1-3