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It wasn’t hard to figure out what happened to the 27-year-old landscaper. The string trimmer he’d been using had thrown a nail directly into his eye.
But aside from this moment of bad luck, all went well for the patient, who isn’t identified in the New England Journal of Medicine Article. A three-dimensional CT (computed tomography) shows just how the nail had been embedded into his eye.
The tip of the nail was just touching a key artery. But it hadn’t punctured it.
It could have gone into his brain. But it didn't.
It could have ruined his vision. But it didn't.
“This patient was extremely fortunate that no crucial structures were injured. In fact, the patient would have had serious functional loss had the trauma occurred literally 1 mm away,” Dr. Katie Pricola Fehnel and colleagues at Boston’s Massachusetts General Hospital wrote in their report.
The team of surgeons scrubbed up. There is no usual protocol for dealing with an injury like this. By definition, each one is different. Blood could spurt from the damaged artery; tissue could stick to the nail.
The team carefully pulled out the nail and to everyone's great relief, the patient barely bled. He was given a tetanus shot and antibiotics. “Even bullets, which are commonly believed to be sterile because they are exposed to heat when fired, may in fact be vectors for infectious organisms,” the team notes.
And even the damage to his eye was not extensive. His vision returned to normal within two months.