Título / Title

RETAINED INTRAOCULAR FOREIGN BODY (IOFB) - CASE REPORT

Introdução / Purpose

To report and discuss a case of retained IOFB with good visual outcome.

Material e Método / Methods

Review of medical records and literature

Resultados / Results

Male, 27 years old, admitted at Botucatu Medical School ER complaining of vision loss and pain 1 month after trauma in left eye (OS) by a foreign body while was mowing the lawn. Visual acuity (VA) in affected eye was 0,15. Slit lamp exam revealed conjunctival hyperemia 2+/4+, small vertical laceration in nasal cornea with stromal edema 2+/4+, deep anterior chamber, trophic iris, pupil reactivity preserved, clear lens. Intraocular pressure (IOP) 12/9. Fundus exam obscured by corneal opacity. Ultrasound revealed hyperechoic image inferior to the lens, with trailing reverberation echoes and no retinal or choroidal detachments. Orbit CT scan demonstrated a hyper reflective image in central inferior sector, beneath the lens. Ultrasound Biomicroscopy (UBM) was not available at the moment so an anterior chamber exploration with aid of a gonioscopy lens was performed, followed by phacoemulsification and posterior vitrectomy, with no success in finding the FB. Patient was discharged for clinical follow up and presented gradative improvement of corneal edema, inflammation and VA. After 7 weeks of first admission patient had no inflammatory signs and VA 1,0 partial.

Discussão e Conclusões / Conclusion

According to the American Academy of Ophthalmology (AAO) IOFBs, if possible, should always be removed. However, inert bodies that do not cause inflammation, infection or ocular toxicity may not be eligible to surgical removal, especially if more damage can derive from the removal procedure and secondary sequels are not expected onsite.
This presented case of retained IOFB of an apparently inert substance, with a stable course, no inflammatory sings and good visual outcome after the initial surgical exploration leaded to an expectant conduct. VA is sustained (1,0) and patient advised to regular follow up due to the possibility of retinal toxicity.

Palavras Chave

intraocular foreign body, ocular trauma