Hyderabad: Doctors at Sankara Eye Hospital, Hyderabad, successfully treated a three-year-old boy who sustained a rare orbital injury after an accidental air gun pellet entered his face and migrated close to the eye.
The child was referred to Sankara Eye Hospital after multiple initial consultations failed to detect the seriousness of the injury. The incident occurred while the child was playing with cousins when an air gun pellet was accidentally discharged, entering through the root of the nose.
Although initial X-rays at a local hospital did not reveal the presence of the pellet and the child was discharged with conservative treatment, the parents noticed a bluish discolouration on the upper eyelid a few days later. This prompted further evaluation and referral to Sankara Eye Hospital, Hyderabad, for specialist care.
Detailed examination and imaging revealed a metallic pellet measuring approximately 7–8 mm lodged extremely close to the eyeball. The child underwent a successful anterior orbitotomy with foreign body removal under general anaesthesia. The procedure was performed by Dr Sirisha Polkampally, Consultant – Orbit & Oculoplasty and Cataract Surgeon at Sankara Eye Hospital, Hyderabad.
Dr Sriram Simakurthy, Chief Medical Officer, Sankara Eye Hospital, Hyderabad, said, “This case underscores the importance of thorough evaluation in pediatric injuries, even when symptoms appear mild. Timely diagnosis and specialist intervention are critical to preventing long-term complications and protecting a child’s vision.”
The surgery was technically challenging, as the pellet, though appearing superficial, was deeply embedded in the orbital tissue and located close to the lacrimal drainage system, which is responsible for tear flow. Meticulous precision was required to avoid damage to surrounding structures.
Dr Sirisha Polkampally added, “The pellet had entered through the nasal root and was gradually moving towards the eye. Careful dissection was essential to remove it safely without affecting vital structures, particularly the lacrimal apparatus.”
The procedure was completed successfully, and the child recovered well post-surgery, preventing possible future complications involving the eye and surrounding tissues.
This case highlights the importance of advanced imaging, specialist expertise, and timely referral in managing pediatric ocular trauma. Equipped with specialised infrastructure and experienced clinicians, Sankara Eye Hospital, Hyderabad, continues to deliver advanced and compassionate eye care for complex cases, especially in children.