Abstract
Purpose. Ocular siderosis (OS) is a sight threatening complication of retained iron-containing Intraocular Foreign Body (IOFB). Successful localization of the IOFB and timely removal are crucial to its management. The purpose of this study was to review the presentation, management, and outcome of OS at our institution. Methods. A retrospective case series of eyes with OS that underwent IOFB removal from January 2009 to March 2015 at our institution. Results. OS was seen in 9 eyes of 9 patients during the study period. There were 8 males and 1 female with an age range of 31.6 years. An IOFB was in all the eyes. The most common features of siderosis were cataract and pigmentary retinopathy seen in 6 (67%) and 4 (44%) eyes, respectively. Electroretinogram (ERG) readings were reduced in the 9 eyes. The IOFB was removed by pars plana vitrectomy in all the cases with improvement in ERG amplitudes occurring postoperatively in 7 (78%) eyes. Conclusion. A retained iron-containing IOFB can manifest itself after several years with features of OS. A careful clinical and radiologic evaluation is imperative in patients with history suggestive of penetrating ocular injury to rule out retained or occult IOFB and thus prevent this catastrophic condition.
Highlights
Ocular siderosis (OS) is a severe sequel of retained ironcontaining Intraocular Foreign Body (IOFB) [1]
A ferrous IOFB undergoes dissociation resulting in the deposition of iron in the intraocular epithelial structures, notably the lens epithelium, iris and ciliary body epithelium, and the sensory retina, where it exerts a toxic effect on cellular enzyme systems, with resultant cell death [2]
Pigmentary retinopathy followed by atrophy of the retina and Retina Pigment Epithelium (RPE) can have a profound effect on vision and result in a subnormal Electroretinogram (ERG) [2]
Summary
Ocular siderosis (OS) is a severe sequel of retained ironcontaining Intraocular Foreign Body (IOFB) [1]. A ferrous IOFB undergoes dissociation resulting in the deposition of iron in the intraocular epithelial structures, notably the lens epithelium, iris and ciliary body epithelium, and the sensory retina, where it exerts a toxic effect on cellular enzyme systems, with resultant cell death [2]. Management of OS depends on the successful detection of an occult IOFB as well as the determination of the need and optimum timing for its surgical removal [3, 4]. The aim of this study was to review the presentation, management, and outcome of this relatively rare disorder at our centre
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