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Cavaillé M, Martin G, Poignet B, Chapron T, Dureau P, Metge F, Caputo G. Intraocular foreign bodies in children: A retrospective case series. J Fr Ophtalmol 2024; 47:104188. [PMID: 38636198 DOI: 10.1016/j.jfo.2024.104188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 11/21/2023] [Accepted: 12/15/2023] [Indexed: 04/20/2024]
Abstract
INTRODUCTION Open globe injuries are a major cause of visual impairment in children, related to the severity of the trauma or secondary to induced amblyopia. Intraocular foreign bodies (IOFB) have been reported in approximately one third of cases of open globe injuries. As clinical presentation and management may differ between adults and children, data is lacking about IOFBs in children under 18years of age. The purpose of this study was to assess the clinical characteristics and visual prognosis of ocular trauma associated with intraocular foreign bodies in children. MATERIALS AND METHODS This single-center retrospective study included patients under 18years of age treated for ocular trauma with IOFB. Demographic characteristics, complete initial and final ophthalmological examination, imaging data and details of medical and surgical management were collected. RESULTS Fourteen patients were included (78.6% boys), with a mean age of 10.3years (min 7months-max 17years). In 92.9% of cases, patients were found to have a single IOFB, mostly metallic (71.4%). Posterior segment IOFBs were found in 50% of cases, anterior segment IOFBs in 28.6% and orbital IOFBs in 21.4%. The clinical examination permitted detection of the IOFBs in 50% of cases, while they were visible on CT scan in all cases. The mean initial visual acuity was 20/320, and the mean final visual acuity was 20/125. Endophthalmitis occurred in 2 cases (14%). DISCUSSION Open globe injuries associated with IOFB are severe and sight-threatening. Localization of the IOFB in the posterior segment has a worse prognosis. CT scan is mandatory, especially in children, as the trauma history is often missing. Retinal detachment and endophthalmitis appear to be the main prognostic factors requiring urgent specialized pediatric ophthalmology management.
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Affiliation(s)
- M Cavaillé
- Ophthalmology Department, Rothschild Foundation Hospital, 75019 Paris, France.
| | - G Martin
- Ophthalmology Department, Rothschild Foundation Hospital, 75019 Paris, France
| | - B Poignet
- Ophthalmology Department, Hôpital Pitié-Salpêtrière, Paris, France
| | - T Chapron
- Ophthalmology Department, Rothschild Foundation Hospital, 75019 Paris, France
| | - P Dureau
- Ophthalmology Department, Rothschild Foundation Hospital, 75019 Paris, France
| | - F Metge
- Ophthalmology Department, Rothschild Foundation Hospital, 75019 Paris, France
| | - G Caputo
- Ophthalmology Department, Rothschild Foundation Hospital, 75019 Paris, France
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Amy CM, Hang YT, Singh NDG, Stanley PF. Retained anterior chamber graphite foreign body with delayed inflammation. Am J Ophthalmol Case Rep 2021; 23:101181. [PMID: 34401602 PMCID: PMC8358414 DOI: 10.1016/j.ajoc.2021.101181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 05/26/2021] [Accepted: 07/24/2021] [Indexed: 11/05/2022] Open
Abstract
Purpose To report a case of retained anterior chamber graphite foreign body with subsequent inflammation 20 years later. Observations A 29-year-old female who presented with first episode of acute blurring of vision and eye redness was noted to have a retained intraocular graphite foreign body in her anterior chamber. She recalled being accidently hit by a mechanical pencil 20 years ago. Conclusions and importance Retained intraocular graphite foreign bodies are inert and generally do not cause inflammation. This is the longest reported duration of retained anterior chamber graphite foreign body that developed subsequent inflammation and corneal endothelial damage only 20 years later.
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Affiliation(s)
- Chan Minhui Amy
- Department of Ophthalmology and Visual Sciences, Khoo Teck Puat Hospital, 90 Yishun Central, 768828, Singapore
| | - Yeo Tun Hang
- Department of Ophthalmology and Visual Sciences, Khoo Teck Puat Hospital, 90 Yishun Central, 768828, Singapore
| | - Neha D/O Gulab Singh
- Department of Ophthalmology and Visual Sciences, Khoo Teck Puat Hospital, 90 Yishun Central, 768828, Singapore
| | - Philip Francis Stanley
- Department of Ophthalmology and Visual Sciences, Khoo Teck Puat Hospital, 90 Yishun Central, 768828, Singapore
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Kumar V, Surve A, Balasubramaniam N, Azad S, Venkatesh P. Retained intraocular copper foreign body presenting as subretinal abscess. Can J Ophthalmol 2019; 54:e254-e258. [PMID: 31564371 DOI: 10.1016/j.jcjo.2018.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 12/11/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Vinod Kumar
- Vitreo-retina, Trauma and Uvea Services, All India Institute of Medical Sciences, New Delhi, India; Dr. Rajendra Prasad Center for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Abhidnya Surve
- Vitreo-retina, Trauma and Uvea Services, All India Institute of Medical Sciences, New Delhi, India; Dr. Rajendra Prasad Center for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
| | - Niranjana Balasubramaniam
- Dr. Rajendra Prasad Center for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Shorya Azad
- Vitreo-retina, Trauma and Uvea Services, All India Institute of Medical Sciences, New Delhi, India; Dr. Rajendra Prasad Center for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Pradep Venkatesh
- Vitreo-retina, Trauma and Uvea Services, All India Institute of Medical Sciences, New Delhi, India; Dr. Rajendra Prasad Center for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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Yang X, Liu C, Liu L, Zhang L. A missed diagnosis of multiple intraocular foreign bodies for 21 years. Cont Lens Anterior Eye 2017; 40:432-435. [PMID: 28844655 DOI: 10.1016/j.clae.2017.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 06/17/2017] [Accepted: 08/15/2017] [Indexed: 02/05/2023]
Abstract
A 30-year-old patient went to the emergency department because of a chemical burn to the left eye more than 10 days ago by toilet cleanser. Surprisingly, a small piece of glass was found in the inferior anterior chamber in the same eye. The visual acuity was counting fingers. There was conjunctival congestion, corneal oedema and Descemet's membrane striae. And there was also a corneal leukoma around 4 to 5 o'clock. Through repeated questioning he recalled that he was injured by an exploded light bulb around 21 years ago. He was asymptomatic until he saw "something moving" in front of the left eye one month ago. Computed tomography (CT) scanning, ultrasonography, ultrasound biomicroscopy (UBM), anterior segment optical coherence tomography (AS-OCT) verified the presence of multiple intraocular foreign bodies (IOFBs) in the anterior chamber and vitreous cavity. B-scan verified the IOFB in the vitreous cavity. Thus, he was diagnosed with corneal chemical burn, IOFBs and corneal leukoma of the left eye. The IOFB in the anterior chamber was removed through surgery. An attempt was made to remove the IOFB in the vitreous cavity with electromagnet, but it was not successful. Vitrectomy could not be performed as it was hindered by the opacity of cornea. After surgery, the visual acuity remained counting fingers and the corneal oedema still existed. This case is a reminder that a detailed history taking, a thorough physical examination and modern imaging techniques are beneficial for establishing the diagnosis and treatment of IOFBs.
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Affiliation(s)
- Xubo Yang
- Department of Ophthalmology, West China Hospital of Sichuan University, 37 Guoxue Xiang, Chengdu, Sichuan, 610041, PR China; Department of Optometry and Visual Science, West China Hospital of Sichuan University, 37 Guoxue Xiang, Chengdu, Sichuan, 610041, PR China
| | - Chunling Liu
- Department of Ophthalmology, West China Hospital of Sichuan University, 37 Guoxue Xiang, Chengdu, Sichuan, 610041, PR China.
| | - Longqian Liu
- Department of Ophthalmology, West China Hospital of Sichuan University, 37 Guoxue Xiang, Chengdu, Sichuan, 610041, PR China; Department of Optometry and Visual Science, West China Hospital of Sichuan University, 37 Guoxue Xiang, Chengdu, Sichuan, 610041, PR China.
| | - Lanlan Zhang
- Department of Ophthalmology, West China Hospital of Sichuan University, 37 Guoxue Xiang, Chengdu, Sichuan, 610041, PR China
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Affiliation(s)
- Shehzad Naroo
- School of Life and Health Sciences, Aston University, Birmingham, UK
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Galvis V, Tello A, Frederick GA, Laiton AN. UUnilateral corneal edema caused by a hidden foreign body. ACTA ACUST UNITED AC 2016; 92:436-438. [PMID: 27443601 DOI: 10.1016/j.oftal.2016.06.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2016] [Revised: 06/06/2016] [Accepted: 06/13/2016] [Indexed: 11/30/2022]
Abstract
CASE REPORT A middle-aged adult male was referred to our institution due to unilateral corneal edema for a possible corneal transplant. At first, the patient denied a history of trauma. A small foreign body, which had been overlooked by the primary ophthalmologist, was detected by gonioscopy, embedded in the anterior chamber angle. It was successfully surgically removed and visual results were good. DISCUSSION In any patient with unilateral unexplained corneal edema, it is necessary to rule out the presence of a foreign body in the anterior chamber.
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Affiliation(s)
- V Galvis
- Centro Oftalmológico Virgilio Galvis, Floridablanca, Colombia; Escuela de Medicina, Facultad de Ciencias de la Salud, Universidad Autónoma de Bucaramanga, Bucaramanga, Colombia; Fundación Oftalmológica de Santander FOSCAL, Floridablanca, Colombia
| | - A Tello
- Centro Oftalmológico Virgilio Galvis, Floridablanca, Colombia; Escuela de Medicina, Facultad de Ciencias de la Salud, Universidad Autónoma de Bucaramanga, Bucaramanga, Colombia; Fundación Oftalmológica de Santander FOSCAL, Floridablanca, Colombia.
| | - G A Frederick
- Escuela de Medicina, Facultad de Ciencias de la Salud, Universidad Autónoma de Bucaramanga, Bucaramanga, Colombia
| | - A N Laiton
- Centro Oftalmológico Virgilio Galvis, Floridablanca, Colombia; Escuela de Medicina, Facultad de Ciencias de la Salud, Universidad Autónoma de Bucaramanga, Bucaramanga, Colombia
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Abstract
Open globe injury (OGI) is a severe form of eye trauma estimated at 2-3.8/100,000 in the United States. Most pediatric cases occur at home and are the result of sharp object penetration. The aim of this article is to review the epidemiology, diagnosis, management, and prognosis of this condition by conducting a systematic literature search with inclusion of all case series on pediatric OGI published between 1996 and 2015. Diagnosis of OGI is based on patient history and clinical examination supplemented with imaging, especially computed tomography when indicated. Few prospective studies exist for the management of OGI in pediatric patients, but adult recommendations are often followed with success. The main goals of surgical management are to repair the open globe and remove intraocular foreign bodies. Systemic antibiotics are recommended as medical prophylaxis against globe infection, or endophthalmitis. Other complications are similar to those seen in adults, with the added focus of amblyopia therapy in children. Severe vision decline is most likely due to traumatic cataracts. The ocular trauma score, a system devised to predict final visual acuity (VA) in adults, has proven to be of prognostic value in pediatric OGI as well. Factors indicating poor visual prognosis are young age, poor initial VA, posterior eye involvement, long wound length, globe rupture, lens involvement, vitreous hemorrhage, retinal detachment, and endophthalmitis. A thorough understanding of OGI and the key differences in epidemiology, diagnosis, management, and prognosis between adults and children is critical to timely prevention of posttraumatic vision loss early in life.
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Affiliation(s)
- Xintong Li
- Department of Ophthalmology, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Marco A Zarbin
- Department of Ophthalmology, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Neelakshi Bhagat
- Department of Ophthalmology, Rutgers New Jersey Medical School, Newark, NJ, USA
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Gokmen O, Yesilirmak N, Kal A, Eroglu FC. Unusual presentation of an intraocular foreign body retained for sixty years. Cont Lens Anterior Eye 2013; 37:234-5. [PMID: 24332359 DOI: 10.1016/j.clae.2013.11.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2013] [Accepted: 11/20/2013] [Indexed: 11/17/2022]
Abstract
Intraocular foreign bodies may remain quiescent for many years particularly if they are not metallic. We report a case of a missed intraocular stone foreign body that had remained asymptomatic underneath the iris for 60 years and appeared during cataract surgery.
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Affiliation(s)
- Onur Gokmen
- Department of Ophthalmology, Baskent University, Faculty of Medicine, Ankara, Turkey
| | - Nilufer Yesilirmak
- Department of Ophthalmology, Baskent University, Faculty of Medicine, Ankara, Turkey.
| | - Ali Kal
- Department of Ophthalmology, Baskent University, Faculty of Medicine, Ankara, Turkey
| | - Fatma C Eroglu
- Department of Ophthalmology, Baskent University, Faculty of Medicine, Ankara, Turkey
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