Abstract
PURPOSE: The diagnosis of retained intraorbital organic foreign body can pose significant challenges without corroboration from a detailed patient history even when presented with clear and accurate imaging. OBSERVATIONS: We present a case of a 65-year-old woman with an upper lid lesion that she noticed 1.5 years ago which subsequently became inflamed four weeks before evaluation. A one cm-long green plant stem was removed from a superior orbital tract, leading to symptom resolution. The patient recalled a fall three years prior, during which the initial embedding occurred. Following the fall, she experienced binocular diplopia for two months which spontaneously resolved. CONCLUSIONS AND IMPORTANCE: We believe this is one of the first cases of a retained intraorbital organic foreign body that initially presented with symptoms, resolved, and subsequently presented years later with different symptoms, leading to the discovery of the foreign body. This case serves as an important reminder to physicians that retained organic foreign bodies can have long quiescent periods and delayed clinical presentations.