Intraocular foreign body: Characteristics, visual outcomes, and predictive values of ocular trauma score

Abstract

Introduction: Retained intraocular foreign body (IOFB) remains an important cause of acquired visual impairment. The visual prognosis following treatments for eyes with retained IOFB was observed to be distinct from other mechanisms of open globe injury due to the specific nature and associated circumstances. This study evaluated the risk behaviors, visual results, and predictive values of Ocular Trauma Score (OTS) in determining visual outcomes in patients with IOFB that were not related to terrorism.

Methods: Medical records of patients who underwent surgical interventions between January 2015 and December 2020 were retrospectively reviewed.

Results: A total of one hundred and sixty-one patients (162 eyes) were recruited. The patients had a mean (standard deviation) age of 47.6 (14.0) years with working male predominance (93.2%). The majority of patients were injured by activities related to grass trimming (63.4%) and metallic objects were the main materials causing injuries (75.7%). Following treatments, the proportion of eyes having vision worse than 20/400 decreased from 126 eyes (77.8%) to 55 eyes (33.9%) at final visit. Ocular trauma score (OTS) had a high potential prediction for final vision in eyes in OTS categories 4 and 5. However, the discordance of final visual acuity distribution was observed in some subgroups of eyes in OTS categories 1 to 3.

Conclusion: This study highlights the significance of IOFB related eye injuries in a tertiary care setting. Decision making on treatments should be carefully considered, particularly in eyes in lower OTS categories, in light of a rise in the proportion of patients who experience improved vision after IOFB removal.

Keywords: Characteristics; Intraocular foreign body; Ocular trauma score; Visual outcomes.

Fig. 1

Proportion of patients with intraocular foreign body by age group and gender.

Fig. 2

Proportion of patients with intraocular foreign body by age group and related activities.

Fig. 3

Proportion of patients with intraocular foreign body by age group and causative object.

Fig. 4

Images of a 43-year-old man who was struck by a projectile object while cutting grass 10 h prior to the presentation showing penetrating corneal wound with traumatic cataract and hypopyon in the anterior chamber (A), a hyperdense metallic foreign body in the posterior segment on a CT scan (B), and a 2-mm long metallic foreign body following removal (C).

Fig. 5

Images of a 65-year-old man who had been hit by a flying object while cutting grass 3 weeks earlier showing a self-sealing corneal laceration with peripheral iris defect (A), a hyperdense metallic foreign body embedded in the retina with surrounded subretinal fluid beneath major vascular arcade on fundus examination (B), chorioretinal scar at the impact site at six months after IOFB removal (C).