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.

If retinal folds, radiating from a retinal impact site, develop and interfere with vision by reaching into the macula—and even seemingly inconspicuous folds can cause severe visual disturbance—late chorioretinectomy should be considered.^[20]

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).

Inpatient & Outpatient Medications

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

Deterrence/Prevention

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

Complications

Endophthalmitis, corneal scarring, elevated intraocular pressure, cataract, retinal detachment, proliferative vitreoretinopathy, and metallosis (eg, chalcosis, siderosis) are possible complications.^[21]

Prognosis

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

Patient Education

Eye protection when partaking in risky activities (eg, hammering, mowing the lawn) is strongly recommended.^[22]

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Media Gallery

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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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, FRCSC Associate Professor of Ophthalmology and Vision Sciences, Department of Ophthalmology and Vision Sciences, University of Toronto Faculty of Medicine; Ophthalmologist-in-Chief, St Michael's Hospital, Canada

David T Wong, MD, FRCSC 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, Royal College of Physicians and Surgeons of Canada

Disclosure: Serve(d) as a speaker or a member of a speakers bureau for: Novartis, Alcon, Bayer<br/>Received research grant from: Novartis, Alcon, Bayer, Genetech<br/>Received consulting fee from Alcon for consulting; Received consulting fee from Novartis for consulting; Received consulting fee from Bayer for consulting; Received consulting fee from Allergan for consulting; Received consulting fee from B & L for 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, Canadian Ophthalmological Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Simon K Law, MD, PharmD Clinical Professor of Health Sciences, Department 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, Association for Research in Vision and Ophthalmology, American Glaucoma Society

Disclosure: Nothing to disclose.

Steve Charles, MD Founder and CEO of Charles Retina Institute; Clinical Professor, Department of Ophthalmology, University of Tennessee College of Medicine

Disclosure: Received royalty and consulting fees for: Alcon Laboratories.

Chief Editor

Inci Irak Dersu, MD, MPH Associate Professor of Clinical Ophthalmology, State University of New York Downstate College of Medicine; Attending Physician, SUNY Downstate Medical Center, Kings County Hospital, and VA Harbor Health Care System

Inci Irak Dersu, MD, MPH is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society

Disclosure: Nothing to disclose.

Additional Contributors

Andrew W Lawton, MD Neuro-Ophthalmology, Ochsner Health Services

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

Disclosure: Nothing to disclose.