This patient was hammering so hard that a piece of metal was sent flying through his upper lid, into his orbit, bounced off the orbital roof, penetrated his globe from behind in the superior midperiphery, and lodged in the inferior retina.
The eye looked completely normal externally since the penetrating injury occurred from behind the eye. The entrance wound through the upper lid was also self-sealing, and the lid looked fairly normal when he presented a few days after the injury.
Take a look at the metal object on the CT scan and the removed foreign body.
Learning Points:
Siderosis can develop from metallic intraocular foreign bodies (specifically iron) and lead to cataract, glaucoma, iris defects, and retinal degeneration with depressed ERG potentials.
