Pterygium surgery combined with the removal of a missed occult iris foreign body detected incidentally during pterygium examination: a case report

Zhitao Su,Xiaodan Huang,Jianyun Fu,Li Zhang,Xin Xie,Houfa Yin,Panpan Ye

doi:10.1186/s12886-018-1020-y

Abstract

BackgroundAn occult foreign body may be retained in patient with small self-sealing wound and no decreased visual acuity without complete examination. Here we report a case of a retained occult ferrous iris foreign body detected incidentally during pterygium examination.Case presentationA 69-year-old man presented to our ophthalmology department because of foreign body sensation and persistent redness in both eyes for 2 years. In the left eye, a pterygium, paracentral corneal opacity and a vertically oval pupil were observed. Ultrasound biomicroscopy and gonioscopy revealed a retained metallic-like foreign body partially embedded in the inferior peripheral iris. Pterygium surgery and the removal of the retained iris foreign body were performed simultaneously. No recurrent pterygium or residual foreign body was found during follow-up.ConclusionsA thorough history should be obtained and complete physical examination should be performed in patients with ocular self-sealing wounds to prevent missed intraocular foreign bodies, which may result in potential sight-threatening ocular complications.

Highlights

An occult foreign body may be retained in patient with small self-sealing wound and no decreased visual acuity without complete examination
The natural progression of a retained intraocular foreign body (IOFB) varies depending on its size and location, the toxicity of the material, and risk of infection [7]
* Correspondence: suzhitao@zju.edu.cn 1Eye Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, No 88 Jiefang Rd, Hangzhou 310009, China Full list of author information is available at the end of the article by retained IOFBs have been reported [10,11,12,13]

Summary

Introduction

An occult foreign body may be retained in patient with small self-sealing wound and no decreased visual acuity without complete examination. Conclusions: A thorough history should be obtained and complete physical examination should be performed in patients with ocular self-sealing wounds to prevent missed intraocular foreign bodies, which may result in potential sight-threatening ocular complications. The frequency of intraocular foreign body (IOFB) following penetrating eye injury is approximately 40% [1,2,3].

Results

Conclusion