Intraocular Foreign Bodies
Based on the history alone, the possibility of an IOFB should be thoroughly investigated, or the diagnosis can easily be missed due to the sometimes underwhelming external clinical appearance - Paul Abrams BS
image by: newarta
HWN Suggests
Be an Ocular Foreign Body Fixer
It’s possible for small foreign bodies to enter the globe and then have a self-sealing entry point due to the heat of a penetrating injury. Sometimes patients with intraocular foreign bodies present with a vague history of something getting in their eye but have no obvious external changes, so they initially dismiss the incident...
Imaging may be necessary to further evaluate for intraocular foreign bodies. X-ray or computed tomography (CT) scans of the orbits with 1.0mm to 1.5mm axial and coronal cuts can help detect and localize intraocular foreign bodies when suspected. Magnetic resonance imaging is contraindicated in cases of metallic foreign bodies.
Articles of Interest
Intraocular Foreign Bodies: Clinical Characteristics and Prognostic Factors Influencing Visual Outcome and Globe Survival in 373 Eyes
Intraocular foreign bodies (IOFBs) are a leading cause of visual morbidity and blindness, especially in the working population.
Intraocular Foreign Body: A Classic Case of Metal on Metal Eye Injury
This case illustrates the stereotypical history for a metallic IOFB--a young male who is hammering or chiseling metal on metal and feels something strike the eye. Based on the history alone, the possibility of an IOFB should be thoroughly investigated, or the diagnosis can easily be missed due to the sometimes underwhelming external clinical appearance.
Intraocular Foreign Body: Ultrasound and CT Findings
Patients presenting with intraocular foreign body (IOFB) can be easily missed, as they may not complain of vision loss or severe pain. Only a small entry wound may be found on careful examination. However, these seemingly harmless injuries may be vision threatening. The IOFB must be removed surgically in the majority of cases (>90%). Bedside ultrasound is a useful tool in looking for metallic objects. Orbital CT continues to be the exam of choice.
Penetrating orbit injury: challenge to emergency medicine
Penetrating orbital injuries pose a serious threat to vision, ocular motility, and in some cases, life. The setting and causes of eye injury are diverse, but previous studies have demonstrated that the risk and type of injury is often correlated with age, gender, and race. Pediatric ocular injury is often accidental and may be preventable.
Surgical Pearls for Retained Intraocular Foreign Bodies
Intraocular foreign bodies (IOFBs) are present in up to 40% of traumatic ocular injury cases. Surgical removal of an IOFB is perhaps the most unpredictable surgery, especially in the presence of media haze, requiring intense preoperative workup and patient counseling.
Resources
Double Trouble: A Tale of Two Intraocular Foreign Bodies
Imaging might be wise, even when one object is clearly visible.
EyeWiki
Computed tomography provides much more reliable information regarding the size, shape, and localization of the foreign body and is the preferred imaging modality.
Intraocular foreign bodies
Endophthalmitis is a complication in 3%–30% of cases involving intraocular foreign bodies. Therefore, patients with this injury should be given immediate treatment with prophylactic antibiotics. Systemic administration (intravenously or orally) of fluoroquinolones are good options because of their superior intraocular penetration.
StatPearls
Intraocular foreign body (IOFB) is an accidental injury usually resulting from chisel hammering and firearm use. It is a serious ocular condition that can potentially cause permanent vision loss. To avoid the high morbidity associated with this condition, it must be promptly diagnosed and treated.
