Delayed Presentation of Orbito-Cerebral Abscess Caused by Pencil-Tip Injury

In Brief This report describes the clinical and radiologic findings of a child who was stabbed with a pencil tip in his right upper eyelid, in what initially appeared to be an innocuous injury. The child presented again 3 weeks later with a combined orbital and frontal lobe brain abscess. The mechanism of injury is discussed, the orbital and neuro-surgical interventions are detailed, and the medical treatment is presented. Ophthalmologists should have a high index of suspicion for orbital foreign bodies and possible intracranial injury in cases of penetrating eyelid trauma. A patient with seemingly innocuous pencil-tip penetrating upper eyelid injury presented again 3 weeks later with a life-threatening orbito-cerebral abscess.