Anesthetic Considerations for Removal of Bilateral Orbital Foreign Bodies With Suspected Carotid Artery Involvement: A Case Report

TL;DR

This case report discusses the anesthetic challenges and strategies for removing foreign bodies from a patient's eyes with potential carotid artery involvement.

Contribution

The paper presents a novel case highlighting anesthetic strategies for managing complex orbital trauma with carotid artery risks.

Findings

Anesthetic management must minimize intraocular pressure in open globe injuries.

Multidisciplinary coordination is essential for cases involving carotid artery proximity.

Invasive monitoring is required to prevent catastrophic hemorrhage risks.

Abstract

Penetrating ocular trauma and carotid artery involvement each present distinct anesthetic challenges. In patients with suspected open globe injuries, increases in intraocular pressure must be minimized through careful anesthetic and airway management. Concurrent carotid artery involvement carries the risk of catastrophic hemorrhage and requires invasive monitoring and multidisciplinary coordination.

We report the anesthetic management of a 74-year-old male presenting with bilateral orbital penetration by ballpoint pens, with imaging revealing the right pen abutting the internal carotid artery. This case highlights key anesthetic strategies and the importance of coordinated endovascular and surgical planning to ensure patient safety.

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