{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T14:15:48Z","timestamp":1764080148205,"version":"3.44.0"},"reference-count":7,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2025,7,8]],"date-time":"2025-07-08T00:00:00Z","timestamp":1751932800000},"content-version":"unspecified","delay-in-days":7,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003399","name":"Science and Technology Commission of Shanghai Municipality","doi-asserted-by":"crossref","award":["20DZ2270800"],"award-info":[{"award-number":["20DZ2270800"]}],"id":[{"id":"10.13039\/501100003399","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82271122","82388101"],"award-info":[{"award-number":["82271122","82388101"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Shanghai Key Clinical Specialty, Shanghai Eye Disease Research Center","award":["2022ZZ01003"],"award-info":[{"award-number":["2022ZZ01003"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,6,5]]},"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:p>A male in his early 40s presented with a penetrating orbital injury after a nine-centimetre lead sinker was propelled into his right orbit while fishing. He reported pain, ptosis and visual acuity reduced to light perception. X-rays, preferred over CT due to metallic artefacts, revealed the sinker in the inferior orbital fissure with an intact eyeball. Initial surgical extraction attempts triggered a severe vagal response, necessitating endoscopic navigation for safe removal. Postoperatively, despite an intact globe, he developed vitreous haemorrhage and retinal detachment, requiring vitrectomy and silicone oil injection. Three months later, his visual acuity improved to 20\/200, with normal blood lead levels. This case emphasises selecting imaging based on foreign body material, avoiding blind extraction using advanced tools if needed, monitoring for intraocular complications and assessing systemic toxicity risks.<\/jats:p>","DOI":"10.1136\/bcr-2025-265477","type":"journal-article","created":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T04:01:26Z","timestamp":1754884886000},"page":"e265477","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Penetrating orbital injury by a nine-centimetre lead sinker"],"prefix":"10.1136","volume":"18","author":[{"given":"Chaoyu","family":"Lei","sequence":"first","affiliation":[{"name":"State Key Laboratory of Eye Health, Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yinwei","family":"Li","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Eye Health, Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huifang","family":"Zhou","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Eye Health, Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sisi","family":"Zhong","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Eye Health, Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,7,8]]},"reference":[{"key":"2025082701231702000_18.7.e265477.1","doi-asserted-by":"crossref","first-page":"1130","DOI":"10.18240\/ijo.2023.07.19","article-title":"Clinical features, radiological imaging, and treatment strategies of nonmetallic intraorbital foreign bodies: a retrospective analysis","volume":"16","author":"Chai","year":"2023","journal-title":"Int J Ophthalmol"},{"key":"2025082701231702000_18.7.e265477.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0161-6420(01)00982-4"},{"key":"2025082701231702000_18.7.e265477.3","doi-asserted-by":"publisher","DOI":"10.1136\/jrnms-92-82"},{"key":"2025082701231702000_18.7.e265477.4","first-page":"197","article-title":"An unusual case of a retained metallic arrowhead in the orbit and sphenoidal sinus","volume":"49","author":"Datta","year":"2001","journal-title":"Indian J Ophthalmol"},{"key":"2025082701231702000_18.7.e265477.5","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1053\/j.sult.2012.06.004","article-title":"Role of computed tomography in the assessment of intraorbital foreign bodies","volume":"33","author":"Pinto","year":"2012","journal-title":"Semin Ultrasound CT MR"},{"key":"2025082701231702000_18.7.e265477.6","doi-asserted-by":"crossref","first-page":"1373","DOI":"10.1038\/sj.eye.6702876","article-title":"Plain X-ray and computed tomography of the orbit in cases and suspected cases of intraocular foreign body","volume":"22","author":"Saeed","year":"2008","journal-title":"Eye (Lond)"},{"key":"2025082701231702000_18.7.e265477.7","first-page":"RD01","article-title":"Intraocular metallic foreign body: role of computed tomography","volume":"8","author":"Pokhraj P","year":"2014","journal-title":"J Clin Diagn Res"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-265477","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T08:23:23Z","timestamp":1756283003000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-265477"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7]]},"references-count":7,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2025,7,8]]},"published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1136\/bcr-2025-265477"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-265477","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2025,7]]}}}