This 23YO male was referred for a second opinion regarding a traumatic intraocular foreign body that occurred about 5 months earlier.
The patient said he was pumping a large truck tire when the tube detached from the valve on the wheel. Metal powder then shot up from the ground and hit the eye. The initial surgical repair involved solely suturing the anterior wound. The foreign body was likely metallic but of an unknown type. The patient was asking why the foreign body had been left. Vision was 20/20.
Fundus photography shows a nodular fibrotic scar in the temporal midperiphery. Widefield OCT shows inner retinal hyperreflectivity with posterior shadowing from this lesion.
Learning Points:
Siderosis can develop from metallic intraocular foreign bodies (IOFBs, specifically iron) and cause cataract, glaucoma, iris defects, and retinal degeneration with depressed ERG. In this case, we felt no need to remove the IOFB given the encasement by scar tissue, lack of inflammation, and excellent vision. We plan on initially examining him monthly.
