Penetrating trauma with permanence of an intraocular foreign body: diagnosis and late treatment

Abstract

Objective: To present a case of an intraocular foreign body emphasizing the diagnosis and late treatment. Case details: Patient, 71 years old, resident of a rural area, reported perforation of the left eyeball, rescued at a health unit where they underwent suture in the cornea at the time. Approximately 131 days ago, after suffering the injury, she was referred to our service with a complaint of low visual acuity in the Left Eye (OI). Ophthalmological examination showed visual acuity with correction in Right Eye (OD) 20/20 and OI only light perception. Biomicroscopy of the OD showed no changes, in the OI there was a corneal scar, central leukoma extending to the temporal periphery showing the entrance door of the Foreign Body (FB), lesion and sutures in the cornea, conjunctival hyperemia and, due to the clinical appearance, characterizing a nodular episcleritis. The lens had central opacity with iris pigment. On ultrasound of the OI, she showed a hyper-reflective mass, high acoustic peak, suggesting Intraocular Foreign Body (IOFBs). Final considerations: After diagnosis, the patient was referred for surgery and removal of the FB. Thus, one should always precede the therapeutic act with imaging exams capable of allowing the correct location and dimensioning of the FB, to ensure adequate therapeutic and surgical planning, so that the damage to vision is reduced.