Abstract
Orbital foreign bodies, especially organic materials, can cause severe eye and orbital damage. Orbital apex syndrome (OAS), a complex condition affecting multiple cranial nerves, is often caused by trauma, among other factors. The patient was a three-year-old boy who fell onto a tree stump three days prior. He presented to the emergency department with left-sided eyelid edema, ptosis, traumatic mydriasis, numbness, and ophthalmoplegia and was diagnosed with OAS. Despite treatment with intravenous methylprednisolone, analgesia, and antibiotics, his condition did not improve after the transnasal endoscopic removal of the foreign body. This case highlights OAS caused by a wooden orbital foreign body requiring prompt, multidisciplinary surgical intervention. Early diagnosis and prompt intervention are crucial to preventing devastating outcomes like OAS and permanent visual impairment. Given the limited understanding of this condition, further research is essential to optimize management strategies and improve patient outcomes.