Intraocular Foreign Body Workup

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

Laboratory Studies

  • Culture an intraocular foreign body (IOFB) or a sample of vitreous if an infection is suspected. Remember that a positive result does not mean that an infection is occurring and that a negative result does not preclude the possibility of endophthalmitis.[6]
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Imaging Studies

  • CT scans are the imaging study of choice for IOFB localization.
    • A consultation with the CT technician is helpful in selecting the optimal section so as to reduce the risk of a false-negative result.
    • A helical CT scan is the most efficient method to establish a diagnosis. Helical CT scans have a very high identification rate.
    • With conventional CT scans, cuts of 0.5 mm are advised.Metal intraocular foreign body located in the leftMetal intraocular foreign body located in the left temporal pars plana region seen on axial CT scan. Same metallic intraocular foreign body as in previSame metallic intraocular foreign body as in previous image, as seen on coronal CT scan view.
  • Plain x-ray is useful if a metallic IOFB is present and a CT scan is unavailable.
  • MRI is generally not recommended for metallic IOFBs.
  • Ultrasound is a useful tool in localizing IOFBs, and its careful use is possible even if the globe is still open; alternatively, intraoperative use after wound closure can be attempted. The ultrasound biomicroscope may help with IOFBs in the anterior segment.[7, 8]
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Other Tests

  • Electroretinography is useful if a chronic IOFB is found and siderosis threatens or is present.
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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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