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Adriono GA, Agustiawan R, Fibrian KC, Ardiani LS, Irawati Y. Variations in clinical manifestations and outcomes of penetrating ocular injuries with intraocular foreign bodies: a case series. J Surg Case Rep 2022; 2022:rjac198. [PMID: 35531439 PMCID: PMC9072000 DOI: 10.1093/jscr/rjac198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 04/16/2022] [Indexed: 11/20/2022] Open
Abstract
Intraocular foreign bodies (IOFBs) are the most common emergency cases in ophthalmology causing severe visual impairment to blindness. We present nine male patients with IOFBs, aged 28-64 years old, which displayed a wide spectrum of findings. Based on IOFB location, four cases were intravitreal, two were intraretinal, two were intralenticular and one was intracorneal. The most common material was metal, from hammering projectiles (six patients). The injuries mainly occurred at workplace (five patients). All IOFBs were successfully extracted. Initial visual acuity (VA) ranged from light perception to 20/32; six patients had better final VA, up to 20/20. A wide range of ocular manifestations is associated with IOFBs. Removing retained IOFB procedure is dependent on location, nature, lens opacity and vitreoretinal involvement. Meticulous ocular examination and imaging modality are vital to identify the IOFB presence. Various visual outcomes depend on zone involvement, IOFB size and level of difficulties of surgery.
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Affiliation(s)
- Gitalisa A Adriono
- Department of Ophthalmology, Faculty of Medicine, University of Indonesia, dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
- Retina Service, JEC Eye Hospitals and Clinics, Jakarta, Indonesia
| | | | | | - Lily S Ardiani
- Research, JEC Eye Hospitals and Clinics, Jakarta, Indonesia
| | - Yunia Irawati
- Department of Ophthalmology, Faculty of Medicine, University of Indonesia, dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
- Ophthalmic Trauma Service, JEC Eye Hospitals and Clinics, Jakarta, Indonesia
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Loporchio D, Mukkamala L, Gorukanti K, Zarbin M, Langer P, Bhagat N. Intraocular foreign bodies: A review. Surv Ophthalmol 2016; 61:582-96. [PMID: 26994871 DOI: 10.1016/j.survophthal.2016.03.005] [Citation(s) in RCA: 115] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 03/06/2016] [Accepted: 03/10/2016] [Indexed: 01/15/2023]
Abstract
Intraocular foreign body injuries may result in a wide range of intraocular pathology and visual outcomes based on the mechanism of injury, type of foreign body, and subsequent complications. We have reviewed the literature to describe the epidemiology and mechanisms of such injuries; types of foreign bodies; imaging tools for diagnosis; current trends in management, presurgical, and surgical interventions; as well as visual prognosis and potential complications. The purpose of this review is to familiarize clinicians with the recent advances in diagnosis and management of such injuries.
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Affiliation(s)
- Dean Loporchio
- Institute of Ophthalmology and Visual Science, Department of Ophthalmology, Rutgers New Jersey Medical School, Newark, New Jersey 07103, USA
| | - Lekha Mukkamala
- Institute of Ophthalmology and Visual Science, Department of Ophthalmology, Rutgers New Jersey Medical School, Newark, New Jersey 07103, USA
| | - Kavya Gorukanti
- Institute of Ophthalmology and Visual Science, Department of Ophthalmology, Rutgers New Jersey Medical School, Newark, New Jersey 07103, USA
| | - Marco Zarbin
- Institute of Ophthalmology and Visual Science, Department of Ophthalmology, Rutgers New Jersey Medical School, Newark, New Jersey 07103, USA
| | - Paul Langer
- Institute of Ophthalmology and Visual Science, Department of Ophthalmology, Rutgers New Jersey Medical School, Newark, New Jersey 07103, USA
| | - Neelakshi Bhagat
- Institute of Ophthalmology and Visual Science, Department of Ophthalmology, Rutgers New Jersey Medical School, Newark, New Jersey 07103, USA.
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Kim SE, Park YW, Ahn JS, Son WG, Jeong M, Yoon J, Seo K. C-arm fluoroscopy for the removal of an intraorbital foreign body in a cat. J Feline Med Surg 2011; 13:112-5. [PMID: 21055988 PMCID: PMC10822322 DOI: 10.1016/j.jfms.2010.08.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2010] [Revised: 08/10/2010] [Accepted: 08/20/2010] [Indexed: 11/15/2022]
Abstract
This report describes the clinical manifestations, diagnosis and minimally surgical intervention of a cat with an intraorbital foreign body. A spayed female cat of unknown age was presented with a recurrent cutaneous sinus tract of the left suborbital region. The cat had not vocalized at all since the adoption. A sharp-edged radiopaque foreign body was visualized on dental radiography. Computed tomography outlined the length of the foreign body from the intraorbital soft tissue to the pharynx. The foreign body was removed under the guide of C-arm fluoroscope with minimal skin incision. The surgical site healed completely on the 11th postoperative day, and the cat vocalized normally after healing.
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Affiliation(s)
- Se Eun Kim
- Department of Veterinary Surgery and Ophthalmology, College of Veterinary Medicine and BK21 Program for Veterinary Science, Seoul National University, 599 Gwanak-ro, Gwanak-gu, Seoul 151-742, Republic of Korea
| | - Young Woo Park
- Department of Veterinary Surgery and Ophthalmology, College of Veterinary Medicine and BK21 Program for Veterinary Science, Seoul National University, 599 Gwanak-ro, Gwanak-gu, Seoul 151-742, Republic of Korea
| | - Jae Sang Ahn
- Department of Veterinary Surgery and Ophthalmology, College of Veterinary Medicine and BK21 Program for Veterinary Science, Seoul National University, 599 Gwanak-ro, Gwanak-gu, Seoul 151-742, Republic of Korea
| | - Won Gyun Son
- Veterinary Surgery and Anesthesiology, College of Veterinary Medicine, Seoul National University, 599 Gwanak-ro, Gwanak-gu, Seoul 151-742, Republic of Korea
| | - Manbok Jeong
- Department of Veterinary Surgery and Ophthalmology, College of Veterinary Medicine and BK21 Program for Veterinary Science, Seoul National University, 599 Gwanak-ro, Gwanak-gu, Seoul 151-742, Republic of Korea
| | - Junghee Yoon
- Veterinary Medical Imaging, College of Veterinary Medicine and BK21 Program for Veterinary Science, Seoul National University, 599 Gwanak-ro, Gwanak-gu, Seoul 151-742, Republic of Korea
| | - Kangmoon Seo
- Department of Veterinary Surgery and Ophthalmology, College of Veterinary Medicine and BK21 Program for Veterinary Science, Seoul National University, 599 Gwanak-ro, Gwanak-gu, Seoul 151-742, Republic of Korea
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Abstract
We report a patient with clinical ocular siderosis at the time of presentation but undetectable intraocular foreign body on computed tomography (CT) and ultrasonography. A 24-year-old man suffered from right ocular injury when hammering metal on metal. Slit-lamp examination revealed a small corneal perforating wound and an iris hole, but no intraocular foreign body was found under fundus examination. There was also no evidence of intraocular foreign body on ultrasonography and orbital CT scan. About 1 month later, lens siderosis with cataract formation developed, and the patient received lens extraction with intraocular lens implantation. During the operation, a small (< 1 x 1 x 1 mm in size) intralenticular foreign body of metal material was found and removed. The patient's visual acuity improved from 6/20 to 6/6 on the next day. A patient suspected to have intraocular foreign body should be followed-up closely; it is better to remove the foreign body before siderosis bulbi occurs.
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Affiliation(s)
- Tsung-Tien Wu
- Department of Ophthalmology, Kaohsiung Veterans General Hospital, Kaohsiung, and National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
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Saeed A, Cassidy L, Malone DE, Beatty S. Plain X-ray and computed tomography of the orbit in cases and suspected cases of intraocular foreign body. Eye (Lond) 2007; 22:1373-7. [PMID: 17558386 DOI: 10.1038/sj.eye.6702876] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
AIM To evaluate the roles of plain X-ray and computed tomography (CT) orbital imaging in cases and suspected cases of intraocular foreign body (IOFB). METHODS Retrospective review of clinical and radiological data relating to 204 consecutive cases and suspected cases of IOFB.SettingRoyal Victoria Eye and Ear Hospital, Dublin, Ireland. RESULTS Plain X-rays were performed in the absence of clinically evident ocular penetration in 177 (87%) cases, and no IOFB was demonstrated in any of these radiographs. Twenty-seven (13%) plain X-ray radiographs were obtained in the presence of clinically evident ocular penetration, and an IOFB was clinically visible in 19 (70%) of these cases. CT scans were undertaken in 21 (10%) of the 204 patients. Of these CT images, 9 (43%) and 12 (57%) were undertaken in the absence and presence of clinically evident ocular penetration, respectively. None (0%) and all (100%) of the CT scans obtained in the absence and presence of clinically evident ocular penetration demonstrated an IOFB, respectively. CONCLUSION Plain X-ray and CT orbital imaging are non-contributory in the absence of clinically evident ocular penetration. In the presence of clinically evident ocular penetration, and where an IOFB is clinically visible, plain X-ray orbital radiography may have a role in excluding multiple IOFBs. In the presence of clinically evident ocular penetration, but where an IOFB is not clinically visible, CT orbital imaging remains the investigation of choice, and the role of pre-CT plain X-ray orbital radiography, as recommended by the guidelines of the Royal College of Radiologists, merits re-evaluation.
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Affiliation(s)
- A Saeed
- Department of Ophthalmology, Waterford Regional Hospital, Waterford, Ireland.
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Lin HC, Wang HZ, Lai YH. Occult plastic intravitreal foreign body retained for 30 years: a case report. Kaohsiung J Med Sci 2006; 22:529-33. [PMID: 17098687 DOI: 10.1016/s1607-551x(09)70349-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
A 41-year-old man had suffered trauma to the right eye 30 years ago. In March 1996, he underwent trabeculectomy and peripheral iridectomy under the diagnosis of open angle glaucoma in the right eye. Autoperimetry at that time revealed visual field constriction. In addition, ocular examination showed that the cup/disc ratio of his right eye was increased. Cataract was diagnosed in September 2002 and cataract extraction was performed on October 22, 2002. Aplastic intravitreal foreign body was detected during the operation. However, preoperative B-scan ultrasonography had failed to detect an intraocular foreign body (IOFB), and the previous fluorescein angiography had shown only retinal pigment epithelium changes. This case reminded us that we should be alert to an occult IOFB in the event of ocular trauma, even if none had been detected during prior imaging examinations.
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Affiliation(s)
- Hsien-Chung Lin
- Department of Ophthalmology, Kaohsiung Medical University Hospital, and Department of Ophthalmology, Yuan's General Hospital, Kaohsiung, Taiwan
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Tovar MC, Huguet E, Gomezi MA. Orbital cellulitis and intraocular abscess caused by migrating grass in a cat. Vet Ophthalmol 2005; 8:353-6. [PMID: 16178847 DOI: 10.1111/j.1463-5224.2005.00411.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We report an unusual case of orbital cellulitis in a cat. Drainage via the pterygopalatine fossa and medical treatment were performed. Failure of resolution and loss of ocular structure and visual function with a poor prognosis led to enucleation. During surgery, plant material and purulent exudate were present in the orbit. Histopathology showed an intraocular foreign body of grass that had migrated through the sclera causing a suprachoroidal abscess with choroidal and retinal detachment.
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Affiliation(s)
- Mari Carmen Tovar
- Ophthalmology Department, Veterinary Teaching Hospital of Murcia, Spain.
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Kuhn F, Morris R. Author’s reply. Ophthalmology 2001. [DOI: 10.1016/s0161-6420(00)00560-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Newman DK. Eyelid foreign body mimics an intraocular foreign body on plain orbital radiography. Am J Emerg Med 1999; 17:283-4. [PMID: 10337890 DOI: 10.1016/s0735-6757(99)90125-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Localization of a foreign body detected on plain orbital radiography may be achieved by comparing radiographs taken with the eyes in upgaze and downgaze. Movement of the foreign body with ocular rotation is considered to indicate localization either within the globe itself or within the soft tissues of the orbit closely related to the globe. A case is reported that demonstrates that this radiologic feature may also occur when a foreign body is located within an eyelid because the position of the eyelids also changes on vertical eye movements. An eyelid foreign body may therefore mimic an intraocular foreign body on plain orbital radiography.
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Affiliation(s)
- D K Newman
- Department of Ophthalmology, Addenbrooke's Hospital, Cambridge, United Kingdom
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Jones G. Foreign bodies in the eye. ACCIDENT AND EMERGENCY NURSING 1998; 6:66-9. [PMID: 9677872 DOI: 10.1016/s0965-2302(98)90001-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
'I think I have got something in my eye.' This statement is one of the most common that patients make in any A & E department. For the nurse at triage, it is the beginning of an investigation that should establish a number of important historical facts: 1. How painful is the eye? 2. Is this foreign body of a high or low velocity? 3. What is the foreign body: dust, wood, metal, glass? 4. Was the patient wearing spectacles or contact lenses? 5. Has there been any alteration in the patients vision/sensitivity to light? Establishing these important historical facts will help the nurse determine the likelihood of this injury being a minor or major problem.
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Lehner PS, Webster AD. Hepatitis C from immunoglobin infusions. BMJ (CLINICAL RESEARCH ED.) 1993; 306:1541-2. [PMID: 8518699 PMCID: PMC1677976 DOI: 10.1136/bmj.306.6891.1541-c] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Barnes E, Griffiths M, Elliott A. Intraocular foreign body missed by computed tomography. BMJ (CLINICAL RESEARCH ED.) 1993; 306:1542. [PMID: 8518700 PMCID: PMC1677920 DOI: 10.1136/bmj.306.6891.1542] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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