A high index of suspicion is important in evaluating any penetrating orbital injury. Likewise, any chronically infected orbit must be suspected of harboring an IOrbFB. Careful history and examination are mandatory for both clinical and medicolegal purposes. Appropriate imaging studies, usually including CT scanning, must be employed. Antibiotic therapy may be crucial in preventing infectious complications, including those involving the central nervous system. The decision regarding surgery must be individualized and should consider visual status, form and composition, and localization of an IOrbFB. The possibility of orbitocranial extension should always be considered and ruled out. Following these general rules, an injury with a small but real potential for clinical disaster may be mitigated, and visual and neurological outcome may be optimized.