A review of intraocular foreign body injuries and their management in the Palestinian territories 2000–2009

Abstract

PurposeTo review the causes, management and outcomes of intraocular foreign body (IOFB) injuries presenting to St. John's Eye Hospital in Jerusalem between January 2000‐ December 2004 and Dr Kanawati Eye Centre in the Palestinian Territories between May 2006–September 2009.MethodsRetrospective review of medical records of patients who underwent surgical treatment for IOFB injuries. Rubber bullet injuries and enucleation/evisceration as a primary repair were excluded.Results51 eyes of 49 patients (46 males & 3 females) underwent surgical removal of IOFB. Mean age was 26 years (range 5–62). 33 eyes (65%) were due to Hammering without protective goggles and 88% were due to Metallic IOFB. 38 eyes (75%) underwent pars plana vitrectomy with 20 (39%) had lensectomy, intraocular lens 14 (27%), endolaser/indirect laser/cryotherapy 31 (61%), explant 10 (20%), internal tamponade 23 (45%), membrane peel 3 (6%) and intravitreal antibiotics and/or steroids 19 (37%). 8 eyes (16%) had IOFB removed from anterior chamber and transcleral approach in 2 eyes (4%). Visual acuity (VA) at presentation varied with (61%) having Snellen 6/60 or worse. Postoperatively, 35% had 6/6–6/9, 10% had 6/12–6/18, 8% had 6/24–6/36 and 29% had 6/60 or worse. Causes of poor visual outcome were due to retinal detachments (40%) and macular pathology (33%). The remaining 27% were due to endophthalmitis, phthisis, copper‐related panophthalmitis and suprachoroidal haemorrhage.ConclusionsIOFB injuries are an important cause of blindness in the Palestinian Occupied Territories. Factors leading to poor visual outcome include IOFB material, poor presenting VA and the presence of vitreoretinal complications due to late presentation. Not only do these injuries affect manual labour workers, but also affect both adults and children as a result of military trauma.