Background: Air-gun injuries with localisation of the pellet at the apex of the orbital cavity can cause difficult decisions in diagnostics and therapy, especially if you decide to retain the foreign body.
Methods: We report on a 14-year-old boy who was hit by an air-gun pellet. The foreign body went into the left orbit without damaging the globe or the optic nerve.
Results: The visual acuity was 1.0, the mobility was only slightly disturbed. A systemic therapy with antibiotics and corticosteroids could stop a series of relapses very well.
Conclusions: Foreign bodies of the orbit can be retained if it is possible to deal with the surrounding reactions properly by conservative therapy.