Intraocular Foreign Body 

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

Background

Intraocular foreign bodies (IOFBs) are rather variable in presentation, outcome, and prognosis. With increased awareness and advanced surgical techniques, the outcome and the prognosis for these potentially devastating injuries have substantially improved.

The most important limiting factor today is the damage occurring at the time of the initial injury. One effective method appears to be prophylactic chorioretinectomy (see Surgical Care), which reduces the risk of postinjury proliferative vitreoretinopathy (PVR).

Metal intraocular foreign body located in the leftMetal intraocular foreign body located in the left temporal pars plana region seen on axial CT scan.
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Pathophysiology

The final resting place of and damage caused by an IOFB depend on several factors, including the size, the shape, and the momentum of the object at the time of impact, as well as the site of ocular penetration.[1, 2]

IOFBs transversing the lens are less likely to cause major retinal damage; conversely, a smaller wound size usually means deeper penetration.

In addition to the initial damage caused at the time of impact, the risk of endophthalmitis and subsequent scarring (eg, PVR) play an important role in the planning of the surgical intervention.[3]

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Epidemiology

Frequency

United States

According to the United States Eye Injury Registry (USEIR), the surveillance arm of the American Society of Ocular Trauma (ASOT), the frequency in the United States is 16%. The most common cause is hammering; the incidence over time shows a decrease at the workplace and an increase in the home.[4]

International

The frequency greatly varies (up to 41%) worldwide, depending upon the population surveyed.

Mortality/Morbidity

Most IOFBs cause internal damage, and most will come to rest in the posterior segment. Commonly injured structures include the cornea, the lens, and the retina.

Race

No racial predilection has been found so far.

Sex

According to the USEIR, 93% of patients with IOFBs are male.

Age

According to the USEIR, the average patient is aged 31 years.

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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.

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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.
 
 
 
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