Doctors at a Gurugram hospital performed a five-hour endoscopic endonasal procedure on an 18-year-old boy from Iraq to remove a retained metallic foreign body lodged deep within the right orbit, close to the optic nerve. The teenager had sustained the injury in an explosion nearly a year earlier, resulting in severe trauma to the right eye and loss of approximately 70% of his vision. Despite undergoing multiple procedures, a metal fragment measuring about one centimeter remained embedded in the orbit. He continued to experience pain, particularly with movement of the affected eye.

The location of the retained fragment presented a considerable surgical challenge. It was positioned on the medial side of the optic nerve, making further intervention potentially hazardous in an eye with already compromised vision. A conventional superior orbital approach through craniotomy was considered.…