{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T14:10:59Z","timestamp":1785161459589,"version":"3.55.0"},"reference-count":9,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,7,13]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:p>We report the case of a woman in her 40s who sustained a left transorbital penetrating injury caused by an accidentally discharged nail from a nail gun. On presentation, visual function was preserved despite visible medial canthal penetration. CT demonstrated a medial extraconal trajectory, adjacent to the medial rectus muscle, traversing the ethmoidal air cells and approaching the sphenoid sinus without intracranial involvement or optic nerve damage. Multidisciplinary management involving ophthalmology and otorhinolaryngology enabled controlled external extraction of the foreign body. A hook-like metallic protrusion along the shaft of the nail caused resistance during removal, increasing the risk of secondary tissue injury. The patient achieved complete recovery, with preserved visual acuity and no neurological or functional sequelae. This case highlights the importance of prompt imaging, coordinated surgical planning and structured follow-up in orbital penetrating trauma.<\/jats:p>","DOI":"10.1136\/bcr-2026-274178","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T13:20:30Z","timestamp":1785158430000},"page":"e274178","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Globe-sparing transorbital penetrating injury with sinonasal extension caused by a nail gun"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-2074-9760","authenticated-orcid":false,"given":"Bruno","family":"Guerreiro Dias","sequence":"first","affiliation":[{"name":"Ophthalmology, Hospital de Santa Maria, Lisbon, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernardo","family":"Baptista","sequence":"additional","affiliation":[{"name":"ENT, Hospital de Santa Maria, Lisbon, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo\u00e3o","family":"Levy","sequence":"additional","affiliation":[{"name":"ENT, Hospital de Santa Maria, Lisbon, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael Correia","family":"Bar\u00e3o","sequence":"additional","affiliation":[{"name":"Ophthalmology, Hospital de Santa Maria, Lisbon, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,7,27]]},"reference":[{"key":"2026072706201858000_19.7.e274178.1","first-page":"98","article-title":"Penetrating Orbital Injury: A Narrative Review for Emergency Clinicians","volume":"13","author":"Pirlet","year":"2025","journal-title":"Health Care (Don Mills)"},{"key":"2026072706201858000_19.7.e274178.2","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1097\/IIO.0000000000000503","article-title":"Orbital Penetrating Injuries: A Review on Evaluation and Management","volume":"64","author":"Lin","year":"2024","journal-title":"Int Ophthalmol Clin"},{"key":"2026072706201858000_19.7.e274178.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.survophthal.2006.06.008"},{"key":"2026072706201858000_19.7.e274178.4","doi-asserted-by":"crossref","first-page":"53","DOI":"10.3171\/2010.8.JNS10301","article-title":"Transorbital penetrating injury: case series, review of the literature, and proposed management algorithm","volume":"114","author":"Schreckinger","year":"2011","journal-title":"J Neurosurg"},{"key":"2026072706201858000_19.7.e274178.5","doi-asserted-by":"publisher","DOI":"10.1148\/rg.286085523"},{"key":"2026072706201858000_19.7.e274178.6","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1097\/00002341-199909000-00012","article-title":"The importance of CT scans in planning the removal of orbital-frontal lobe foreign bodies","volume":"15","author":"Fezza","year":"1999","journal-title":"Ophthalmic Plast Reconstr Surg"},{"key":"2026072706201858000_19.7.e274178.7","doi-asserted-by":"crossref","first-page":"1198","DOI":"10.3390\/medicina57111198","article-title":"Clinical Characteristics, Visual Outcomes, and Prognostic Factors of Open Globe Injuries","volume":"57","author":"Puod\u017eiuvien\u0117","year":"2021","journal-title":"Medicina (B Aires)"},{"key":"2026072706201858000_19.7.e274178.8","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.1964.00970010348008"},{"key":"2026072706201858000_19.7.e274178.9","doi-asserted-by":"crossref","first-page":"3339","DOI":"10.2147\/OPTH.S377137","article-title":"Risk Factors for Enucleation Following Open Globe Injury: A 17-Year Experience","volume":"16","author":"Toiv","year":"2022","journal-title":"Clin Ophthalmol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2026-274178","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T13:20:31Z","timestamp":1785158431000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2026-274178"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":9,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7,27]]},"published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1136\/bcr-2026-274178"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2026-274178","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]}}}