Intraocular Foreign Body Follow-up

  • Author: Ferenc Kuhn, MD, PhD; Chief Editor: Hampton Roy Sr, MD   more...
 
Updated: Jul 11, 2011
 

Further Inpatient Care

  • Unless serious complications are present, the patient can be discharged shortly after surgery.
  • Educate the patient about the potential of both early complications (eg, intraocular pressure elevation) and late complications (eg, scarring).
Next

Further Outpatient Care

  • Follow-up visits are necessary for at least 4 months to determine whether proliferative vitreoretinopathy has occurred. Rehabilitation service may be necessary if permanent visual impairment is present.
Previous
Next

Inpatient & Outpatient Medications

  • Topical antibiotics and corticosteroids in the early postoperative period are indicated.
Previous
Next

Deterrence/Prevention

  • Safety eyewear made of polycarbonate (3 mm in thickness) virtually eliminates the risk of intraocular foreign bodies (IOFBs).
Previous
Next

Complications

  • Endophthalmitis, corneal scarring, elevated intraocular pressure, cataract, retinal detachment, proliferative vitreoretinopathy, and metallosis (eg, chalcosis, siderosis) are possible complications.[19]
Previous
Next

Prognosis

  • The prognosis is generally relatively good. Over one half of eyes with IOFB injury regain/retain reading vision.
Previous
Next

Patient Education

  • Eye protection when partaking in risky activities (eg, hammering, mowing the lawn) is strongly recommended.[20]
Previous
 
Contributor Information and Disclosures
Author

Ferenc Kuhn, MD, PhD  Associate Professor of Clinical Ophthalmology, University of Alabama at Birmingham; Consulting Staff, American Society of Ocular Trauma, Helen Keller Foundation for Research and Education, Chief Vitreoretinal Surgeon, Milos Klinika, Belgrade, Serbia

Disclosure: Nothing to disclose.

Coauthor(s)

David T Wong, MD, FRCS(C)  Associate Professor of Ophthalmology and Vision Sciences, Director of Fellowship Programs, Department of Ophthalmology and Vision Sciences, St Michael's Hospital, University of Toronto Faculty of Medicine, Canada

David T Wong, MD, FRCS(C) is a member of the following medical societies: Alpha Omega Alpha, American Academy of Ophthalmology, American Society of Retina Specialists, Association for Research in Vision and Ophthalmology, Canadian Medical Association, Canadian Ophthalmological Society, College of Physicians and Surgeons of Ontario, Ontario Medical Association, and Royal College of Physicians and Surgeons of Canada

Disclosure: Alcon Consulting fee Consulting; Novartis Consulting fee Consulting; Labtician Consulting fee Consulting; Diagnos Royalty Consulting

Louis Giavedoni, MD, FRCSE  Co-Chief, Assistant Professor, Department of Ophthalmology, St Michael's Hospital, University of Toronto, Canada

Louis Giavedoni, MD, FRCSE is a member of the following medical societies: American Academy of Ophthalmology, Canadian Medical Association, and Canadian Ophthalmological Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Andrew W Lawton, MD  Medical Director of Neuro-Ophthalmology Service, Section of Ophthalmology, Baptist Eye Center, Baptist Health Medical Center

Andrew W Lawton, MD is a member of the following medical societies: American Academy of Ophthalmology, Arkansas Medical Society, and Southern Medical Association

Disclosure: Nothing to disclose.

Simon K Law, MD, PharmD  Associate Professor of Ophthalmology, Jules Stein Eye Institute, University of California, Los Angeles, David Geffen School of Medicine

Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, and Association for Research in Vision and Ophthalmology

Disclosure: Nothing to disclose.

Steve Charles, MD  Director of Charles Retina Institute; Clinical Professor, Department of Ophthalmology, University of Tennessee College of Medicine; Adjunct Professor of Ophthalmology, Columbia College of Physicians and Surgeons; Clinical Professor Ophthalmology, Chinese University of Hong Kong

Steve Charles, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Retina Specialists, Club Jules Gonin, Macula Society, and Retina Society

Disclosure: Alcon Laboratories Consulting fee Consulting; OptiMedica Ownership interest Other; Topcon Medical Lasers Consulting fee Consulting

Lance L Brown, OD, MD  Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri

Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD  Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences

Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

References

  1. Boldt HC, Pulido JS, Blodi CF, et al. Rural endophthalmitis. Ophthalmology. Dec 1989;96(12):1722-6. [Medline].

  2. Potts AM, Distler JA. Shape factor in the penetration of intraocular foreign bodies. Am J Ophthalmol. 1986;100:183-187.

  3. Knox FA, Best RM, Kinsella F, et al. Management of endophthalmitis with retained intraocular foreign body. Eye. Feb 2004;18(2):179-82. [Medline].

  4. Brown IA. Intraocular foreign bodies. Nature of injury. Int Ophthalmol Clin. Spring 1968;8(1):147-52. [Medline].

  5. Cooke CA, Mulholland DA. A closer look at anterior segment intraocular foreign bodies. Eye. Apr 2005;19(4):476-8. [Medline].

  6. Mieler WF, Ellis MK, Williams DF, et al. Retained intraocular foreign bodies and endophthalmitis. Ophthalmology. Nov 1990;97(11):1532-8. [Medline].

  7. Coleman DJ, Jack RL, Franzen LA. Ultrasonography in ocular trauma. Am J Ophthalmol. Feb 1973;75(2):279-88. [Medline].

  8. Penner R, Passmore JW. Magnetic vs nonmagnetic intraocular foreign bodies. An ultrasonic determination. Arch Ophthalmol. Nov 1966;76(5):676-7. [Medline].

  9. Kuhn F, Morris R, Witherspoon CD. Intraocular foreign body (posterior segment). In: Masters Techniques in Ophthalmic Surgery. Baltimore: Williams and Wilkins;. 1995:1201-1212.

  10. Zhang Y, Zhang M, Jiang C, Qiu HY. Intraocular foreign bodies in china: clinical characteristics, prognostic factors, and visual outcomes in 1421 eyes. Am J Ophthalmol. Jul 2011;152(1):66-73.e1. [Medline].

  11. Demircan N, Soylu M, Yagmur M, et al. Pars plana vitrectomy in ocular injury with intraocular foreign body. J Trauma. Nov 2005;59(5):1216-8. [Medline].

  12. Thompson JT, Parver LM, Enger CL, et al. Infectious endophthalmitis after penetrating injuries with retained intraocular foreign bodies. National Eye Trauma System. Ophthalmology. Oct 1993;100(10):1468-74. [Medline].

  13. Kumar A, Kumar V, Dapling RB. Traumatic cataract and intralenticular foreign body. Clin Experiment Ophthalmol. Dec 2005;33(6):660-1. [Medline].

  14. Cridland N. Magnetic extraction. Int Ophthalmol Clin. 1986;8(1):213-29.

  15. Kuhn F, Heimann K. [A new permanent magnet for removal of intra-ocular ferromagnetic foreign bodies]. Klin Monatsbl Augenheilkd. Apr 1991;198(4):301-3. [Medline].

  16. Lo Bue TD, Deutsch TA, Lobick J. Detection and localization of nonmetallic intraocular foreign bodies by magnetic resonance imaging. Arch Ophthalmol. 1988;106(2):260-1.

  17. Soheilian M, Abolhasani A, Ahmadieh H, et al. Management of magnetic intravitreal foreign bodies in 71 eyes. Ophthalmic Surg Lasers Imaging. Sep-Oct 2004;35(5):372-8. [Medline].

  18. Michels RG, Rice TA. Bimanual bipolar diathermy for treatment of bleeding from the anterior chamber angle. Am J Ophthalmol. Dec 1977;84(6):873-4. [Medline].

  19. Weissgold DJ, Kaushal P. Late onset of rhegmatogenous retinal detachments after successful posterior segment intraocular foreign body removal. Br J Ophthalmol. Mar 2005;89(3):327-31. [Medline].

  20. Lubniewski A, Olk RJ, Grand MG. Ocular dangers in the garden. A new menace--nylon line lawn trimmers. Ophthalmology. Jul 1988;95(7):906-10. [Medline].

  21. Azad RV, Kumar N, Sharma YR, et al. Role of prophylactic scleral buckling in the management of retained intraocular foreign bodies. Clin Experiment Ophthalmol. Feb 2004;32(1):58-61. [Medline].

  22. Barry DR. Effects of retained intraocular foreign bodies. Int Ophthalmol Clin. Spring 1968;8(1):153-70. [Medline].

  23. Behrens-Braumann W, Praetorius G. Intraocular foreign bodies: 297 consecutive cases. Ophthalmologica. 1989;198(2):84-8.

  24. Coleman DJ, Lucas BC, Rondeau MJ, et al. Management of intraocular foreign bodies. Ophthalmology. Dec 1987;94(12):1647-53. [Medline].

  25. Duker JS, Fischer DH. Occult plastic intraocular foreign body. Ophthalmic Surg. Mar 1989;20(3):169-70. [Medline].

  26. Erakgun T, Akkin C, Mentes J. Management of the posterior segment foreign bodies with a simple snare. Retina. Dec 2003;23(6):858-60. [Medline].

  27. Johnston S. Perforating eye injuries: a five year survey. Trans Ophthalmol Soc U K. 1971;91:895-921. [Medline].

  28. Kuhn F, Mester V, Morris R. A proactive treatment approach for eyes with perforating injury. Klin Monatsbl Augenheilkd. Aug 2004;221(8):622-8. [Medline].

  29. Kuhn F, Mester V, Morris R. Intraocular foreign bodies. In: Ocular Trauma: Principles and Practice. New York: Thieme; 2002:235-263.

  30. Mader TH, Carroll RD, Slade CS, et al. Ocular war injuries of the Iraqi Insurgency, January-September 2004. Ophthalmology. Jan 2006;113(1):97-104. [Medline].

  31. Percival SP. A decade of intraocular foreign bodies. Br J Ophthalmol. Jun 1972;56(6):454-61. [Medline].

  32. Roper-Hall MJ. Review of 555 cases of intraocular foreign body with special references to prognosis. Br J Ophthalmol. 1954;38:65-99.

  33. Smiddy WE, Hamburg TR, Kracher GP, et al. Contact lenses for visual rehabilitation after corneal laceration repair. Ophthalmology. Mar 1989;96(3):293-8. [Medline].

  34. Sternberg P Jr, de Juan E Jr, Michels RG, et al. Multivariate analysis of prognostic factors in penetrating ocular injuries. Am J Ophthalmol. Oct 15 1984;98(4):467-72. [Medline].

  35. Thach AB, Ward TP, Dick JS, et al. Intraocular foreign body injuries during Operation Iraqi Freedom. Ophthalmology. Oct 2005;112(10):1829-33. [Medline].

  36. Williams DF, Mieler WF, Abrams GW, et al. Results and prognostic factors in penetrating ocular injuries with retained intraocular foreign bodies. Ophthalmology. Jul 1988;95(7):911-6. [Medline].

  37. Williams S, Char DH, Dillon WP, et al. Ferrous intraocular foreign bodies and magnetic resonance imaging. Am J Ophthalmol. Apr 15 1988;105(4):398-401. [Medline].

  38. Wong TY, Tielsch JM. A population-based study on the incidence of severe ocular trauma in Singapore. Am J Ophthalmol. Sep 1999;128(3):345-51. [Medline].

  39. Zinreich SJ, Miller NR, Aguayo JB, et al. Computed tomographic three-dimensional localization and compositional evaluation of intraocular and orbital foreign bodies. Arch Ophthalmol. Oct 1986;104(10):1477-82. [Medline].

 
Previous
Next
 
Metal intraocular foreign body located in the left temporal pars plana region seen on axial CT scan.
Same metallic intraocular foreign body as in previous image, as seen on coronal CT scan view.
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.