Intraocular Foreign Body (IOFB) Clinical Presentation

Updated: May 18, 2017
  • Author: Ferenc Kuhn, MD, PhD; Chief Editor: Inci Irak Dersu, MD, MPH  more...
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Presentation

History

A few direct questions should be sufficient for the ophthalmologist to suspect the presence of an IOFB in eyes with an open globe injury.

In case of doubt, it is advisable to err on the side of an IOFB presence. The most common cause for litigation against the ophthalmologist in a trauma case is a missed IOFB. It is important to remember that the patient may be unaware of any object entering (or even striking) the eye, and the vision may be unaffected initially.

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Physical

A complete examination of both eyes is necessary, including the visual acuity.

A corneal entry wound and a hole in the iris provide trajectory information.

The slit lamp is extremely useful in detailing all anterior segment pathologies. [5]

The indirect ophthalmoscope through a dilated pupil may allow direct visualization of the IOFB, which gives the most useful information for the surgeon.

Gonioscopy and scleral depression are not recommended unless the entry wound has been surgically closed.

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Causes

Hammering and using power tools are the most important causes. Protective eyewear, if appropriate (3 mm of polycarbonate), prevents virtually all injuries.

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