Occult Perforating Corneal Injury from Mechanical Pencil Graphite

Management of penetrating injury with retained intraocular lead foreign body from a writing instrument: surgical video with implications for paediatric public health and safety

Penetrating ocular injuries from writing instruments that are thrown, especially by children, in the community can result in significant ocular morbidity. Often these cases present to the accident and emergency department. Accurate and prompt assessment is key in saving sight. We present a case of one such injury and how it was surgically managed.

Eye Injuries from Pencil Lead: Three Cases

Corneal stromal and/or penetrating ocular injuries from pencils and pencil lead are more common in childhood and may lead to intraocular infection or severe intraocular sterile inflammatory reaction. Herein we report 3 children with ocular trauma due to pencil lead injuries. The first case had corneal stromal injury caused by a pencil. In the second case, a pencil perforated the cornea and contacted the iris. In the third case, pencil lead perforated both the cornea and iris and reached the vitreous through the lens zonules. Intracameral triamcinolone (2 mg/0.05 mL) was injected after the pencil lead was removed from the eyeball. Topical anti-inflammatory and cycloplegic drops were prescribed. In conclusion, corneal and especially penetrating ocular injuries from pencil lead may have a good prognosis with the use of appropriate anti-inflammatory and prophylactic antibiotic treatment and follow-up.

Suspected endothelial pencil graphite deposition

A 14-year-old male patient had an ocular trauma with a pencil. Biomicroscopic examination revealed a broken part of pencil into the cornea. Foreign body removal and corneal wound closure were performed in the same day. After corneal repair, there was a grade 4+ anterior chamber reaction just like in preoperative examination. Dilated examination showed a very small piece broken tip of pencil on the upper nasal quadrant of the lens. A small and linear deposition was also seen on endothelial surface. Endothelial deposition and foreign body disappeared with intensive topical steroid treatment.

Asymptomatic Intracorneal Graphite Deposits following Graphite Pencil Injury

Reports of graphite pencil lead injuries to the eye are rare. Although graphite is considered to remain inert in the eye, it has been known to cause severe inflammation and damage to ocular structures. We report a case of a 12-year-old girl with intracorneal graphite foreign bodies following a graphite pencil injury.