A 51-year-old woman with a history of a left orbital floor fracture repaired with stainless steel mesh in 1973 presented for evaluation of chronic head tilt and strabismus. Ocular motility examination revealed severely restricted eye movements with a large-angle esotropia and left hypotropia, and positive forced ductions. Dilated fundoscopic examination was notable for a small metal wire surrounded by hyperpigmentation in the inferonasal quadrant. CT confirmed globe penetration by the mesh floor implant. Although treatment options were contemplated, after further review, observation was chosen. This is a rare case of wire mesh causing a well-tolerated metallic intraocular foreign body and strabismus.
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