This 20YO male developed sudden, painful vision loss in his right eye while welding. Vision was counting fingers. Examination revealed a corneal laceration with a metal wire piercing the iris temporally and stuck in the superior retina with a localized retinal detachment.
Emergent surgery included corneal wound repair, lensectomy, and vitrectomy with removal of the intraocular foreign body (IOFB), fluid-air exchange, and endolaser photocoagulation. Four weeks postoperatively, vision was 20/80 with an aphakic correction, and the retina remained completely attached.
Learning Points:
Penetrating ocular injuries from IOFB are a true ocular emergency. These IOFBs are usually metallic and need to be removed due to the risk of siderosis, endophthalmitis, cataract, glaucoma, iris defects, and retinal degeneration with depressed ERG.
