An unusual case of nine cilia embedded in the retina after a perforating ocular injury

Abstract

Purpose: To report an extremely rare case involving a 41-year-old man with nine intraocular cilia embedded in the retina after a perforating ocular injury caused by a metal wire. This case is particularly rare because of the number and location of the cilia.

Observations: The patient underwent an uneventful corneal suturing and extracapsular extraction of the damaged lens of his right eye. Intraocular foreign bodies were discovered following surgery and were removed at a later date. Following lens extraction and ocular repair, the patient's best-corrected visual acuity (BCVA) was counting fingers. Fundus examination during follow-up revealed several eyelashes embedded in the retina. Thirty-two days after the injury, the patient showed signs of ocular inflammation. Therefore, the patient underwent vitrectomy and intraocular foreign body removal. Nine cilia were embedded in the retina at the posterior perforation site. At the final follow-up visit, his BCVA was 20/25.

Conclusion and importance: This report describes an unusual case where intraocular cilia were embedded in the retina after a perforating ocular injury. The eyelashes caused an intraocular inflammatory reaction that subsided after their removal.

Keywords: Cilia; Ocular foreign body; Retina; Vitrectomy.

Fig. 1

Ultrasound findings for a 41-year old man who presented with a penetrating ocular injury caused by a metal wire An ultrasound image acquired 3 days after injury shows highly reflective, linear echoes in the vitreous cavity, indicating the presence of cilia, and a thickened posterior wall. An eyelash (large arrow), its follicle (thin arrow), and its entrapment at the posterior perforation site (dotted line arrow) can be observed visible.

Fig. 2

A retinography image obtained 23 days after a penetrating ocular injury caused by a metal wire in a 41-year old man. Cilia and their follicles are embedded in the retina.

Fig. 3

A retinography image obtained 26 days after a penetrating ocular injury caused by a metal wire in a 41-year old man Cilia embedded in the retina can be observed after green laser photocoagulation was applied around them. (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)

Fig. 4

An intraoperative photograph obtained during the surgical removal of intraocular cilia 35 days after a penetrating ocular injury caused by a metal wire in a 41-year old man.

Fig. 5

Removal of nine cilia with follicles from the eye of a 41-year old man who incurred a penetrating ocular injury caused by a metal wire 35 days back. The image was obtained immediately after pars plana vitrectomy.

Fig. 6

A fundus photograph obtained 6 months after a penetrating ocular injury caused by a metal wire in a 41-year-old man. Pars plana vitrectomy and intraocular foreign body removal were performed 5 months back. The posterior perforation site is surrounded by laser marks. A thickened posterior hyaloid membrane can be seen.