New classification of ocular foreign bodies

Abstract

Foreign bodies (FBs) in the eye are usually classified as intraocular (IOFB) or extraocular (EOFB). In IOFB the FB is within the eye ball and in EOFB it is outside. This classification seems oversimplified. Hence a new classification is proposed on the basis of FB locations, in which adnexal FBs (in orbit, lids, conjunctiva and lacrimal apparatus) are also included. These are further classified according to their exact location. FBs can also be classified in many other ways. Besides IOFB and EOFB, another condition IMFB (intramural foreign body) is also described. The FBs are situated within cornea or sclera and are neither IOFB nor EOFB. Ocular trauma also includes trauma to ocular adnexa and hence the terms IOFB and EOFB have been replaced by IGFB (intraglobal foreign body) and EGFB (extraglobal foreign body).

Reply to comment on: Systematic analysis of ocular trauma by a new proposed ocular trauma classification

“…Hence, they cannot be included in destructive globe injuries One-third of full-thickness laceration implies one–third of globe circumference. Hence, there is no difference between what we stated in the current classification[ 2 ] and what was described earlier[ 3 ] We appreciate the suggestion to reclassify and expand the system as mixed ocular trauma, which is however difficult to implement. The extensive detail in which the ocular foreign bodies were previously classified[ 3 ] precludes its clubbing with the current system; the resulting classification would be too bulky and difficult to apply in clinical situations.…”

“…[ 1 2 ] Intramural foreign bodies are those that lie within the coats of the eyewall (cornea or sclera). [ 3 ] They are neither intraocular nor extraocular. They are usually very small and do not cause much structural or functional damage.…”

Metallic foreign body in the orbit – case report

“…Among the many divisions of alien bodies in the orbit, classifications based on localization in the anatomical structures of the orbital and surrounding spaces, are most useful for clinicians in establishing a therapeutic treatment plan. Barthendu Shukla developed a division which distinguishes foreign bodies located strictly within the structures of the eyeball and those located in the vicinity of retrobulbar structures [7]. Finkelstein et al divided foreign bodies into those in the the front, located in the area of the eyelids and anterior segment of the eyeball, intraocular and posterior retrobulbar [10].…”

Comment on: Systemic analysis of ocular trauma by a new proposed ocular trauma classification

“…The classification system previously published by the authors is much realistic in classifying the destructive injuries with full thickness laceration and one-third globe circumference. [ 2 ]…”

“…We firmly believe that it is much more imperative to incorporate and comprehend collectively the foreign body injuries within the classification of ocular trauma. [ 2 ]…”