Intraocular foreign body in the anterior chamber angle of the eye—a 30-year-old ‘emergency’

Ali, Nadir; Buscombe, Charlotte; Jones, David H.

doi:10.1093/omcr/omab032

Cited by 3 publications

(1 citation statement)

References 9 publications

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“…[8] When asymptomatic, IOFBs may be easily overlooked and retained for several years before the onset of these complications. [9] Furthermore, metallic IOFBs predispose patients to developing metallosis. Iron-or copper-containing IOFBs can lead to siderosis and chalcosis, respectively, which are visionthreatening diseases that warrant urgent IOFB removal.…”

Section: (B) (A)mentioning

confidence: 99%

Intraocular foreign body in the anterior chamber angle misdiagnosed as herpetic stromal keratitis

Haidar

Çelik

Turhan

2023

Ulus Travma Acil Cerrahi Derg

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We report a case of a metallic intraocular foreign body (IOFB) retained in the anterior chamber (AC) angle that was masquerading as herpetic stromal keratitis. A 41-year-old male construction worker was referred to our ophthalmology clinic with the complaint of consistent blurred vision for 3 days in his left eye. He had no history of ocular trauma. The best-corrected visual acuity was found to be 10/10 in the right eye and 8/10 in the left eye. On slit-lamp examination of the anterior segment, the right eye was normal, while the left eye showed unilateral corneal edema and scarring, anterior lens capsule opacification, +2 cells in the AC, and the Seidel test was negative. Fundus examination was normal bilaterally. Despite there not being history of it, we still suspected ocular trauma considering the patient’s occupational risk. Consequently, an orbital computed tomography imaging was performed which revealed a metallic-IOFB in the inferior iridocorneal angle. On the second follow-up day, the corneal edema regressed, and a gonioscopic examination of the affected eye was performed, showing a small foreign body embedded in the inferior iridocorneal angle of the AC. Subsequently, the IOFB was surgically removed using Barkan lens, and excellent visual results were achieved. This case emphasizes the importance of considering IOFB in the differential diagnosis of patients with unilateral corneal edema and anterior lens capsule opacification. Furthermore, the presence of IOFB should be definitely excluded in patients with occupational risk of ocular trauma even if there is no history of trauma. More awareness about the proper use of eye protection should be raised to circumvent penetrating ocular-trauma.

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Section: (B) (A)mentioning

confidence: 99%

Intraocular foreign body in the anterior chamber angle misdiagnosed as herpetic stromal keratitis

Haidar

Çelik

Turhan

2023

Ulus Travma Acil Cerrahi Derg

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Removal of an anterior chamber foreign body using hydropulsion and ophthalmic viscoelastic device capture in a dog

Wiggans

2024

Veterinary Ophthalmology

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ObjectiveTo describe the removal of an adherent, presumed plant‐based, anterior chamber foreign body (ACFB) from the inferior iridocorneal angle in a dog using hydropulsion and ophthalmic viscoelastic device (OVD) capture.Animal StudiedA 6‐year‐old female spayed pit bull terrier who was referred for further evaluation of a corneal opacity after being observed running into a thorned succulent plant 1 month earlier. On ophthalmic examination, no corneal foreign body was noted, though mild uveitis was present. Gonioscopy revealed a suspected plant foreign body (thorn tip) in the inferior iridocorneal angle.ProcedureUnder general anesthesia, the ACFB was dislodged from the inferior iridocorneal angle using hydropulsion with balanced salt solution. The superior half of the anterior chamber had been filled with 2% hydroxypropyl methylcellulose OVD to trap the foreign object. One month later, the uveitis had resolved and repeat gonioscopy confirmed the absence of any ACFB in the iridocorneal angle.ConclusionIn the absence of an intraoperative goniolens or endoscopy, hydropulsion and OVD capture of adherent ACFBs may be a feasible option for removal.

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Longstanding iris foreign body to treat or not to treat!

Ramesh,

Umesh,

Minija

2024

Indian Journal of Ophthalmology - Case Reports

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A 61 year female presented with whitish discolouration of left eye noticed few days ago with a forgotten history of trauma 28 years ago for which a consultation was made and was asked for review with orbital x-ray, which was not done as she was asymptomatic. On examination, her best corrected visual acuity was 6/6 both eyes. Examination of right eye was unremarkable except for early lens changes, while left eye showed a nebular corneal opacity, suggesting entry wound. A brown coloured foreign body was seen stuck to iris surface temporally, measuring 4*3mm with degenerative changes over it and exposing underlying pigment epithelium with focal cataract. Rest of anterior segment, gonioscopy and fundus examination were normal. A thorough search for other intraocular foreign bodies (IOFBs) was made, revealing no other IOFBs. Anterior segment optical coherence tomography (AS-OCT) and ultrasound biomicroscopy (UBM) demonstrated foreign body limited to iris surface, while orbital x-ray showed no evidence of metallic foreign body and electroretinogram (ERG) showed mildly decreased amplitude of b-wave. Plan for foreign body removal with cataract surgery was made as per patient’s request for cosmesis, and was retrieved through viscoexpression after a failed attempt to remove it through magnetic forceps thereby confirming its non-metallic nature. Special care was taken during capsulorhexis to not damage the intact capsule. Rest of cataract surgery was performed as usual and anterior chamber wash was done to flush all the debris. Post operative picture shows an area of partial and full thickness iris defect while maintaining a good visual acuity. The debate for removal of longstanding, well encapsulated, inert foreign body over iris without functional impairment depends on multiple factors.[1,2] Which in our case was due to the patient’s demand for cosmesis. Video link: https://youtu.be/pC3ZRoqxB8o

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Intraocular foreign body in the anterior chamber angle of the eye—a 30-year-old ‘emergency’

Cited by 3 publications

References 9 publications

Intraocular foreign body in the anterior chamber angle misdiagnosed as herpetic stromal keratitis

Intraocular foreign body in the anterior chamber angle misdiagnosed as herpetic stromal keratitis

Removal of an anterior chamber foreign body using hydropulsion and ophthalmic viscoelastic device capture in a dog

Longstanding iris foreign body to treat or not to treat!

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