PURPOSE: To evaluate the baseline characteristics, intraoperative choices and outcomes of the surgical management of open globe injuries. SETTING: Longitudinal, monocentric, retrospective study, conducted at the University Hospitals of Geneva. METHODS: All cases of adults were included with an open globe injury, with or without an intraocular foreign body (IOFB), at a tertiary university centre and for the period between January 2013 and July 2023. The primary outcome was the eye status at the final follow-up visit (defined as the anatomical final outcome). Secondary outcomes included the final best-corrected visual acuity (BCVA), the number of surgical interventions required to stabilise the eyes and the adverse events (AEs). RESULTS: 37 eyes of 37 patients were included. The main type of penetrating injury was through a scleral wound (51.4%; n = 19), and the main cause of injury was occupational (46.0%; n = 17. Nine patients (n = 24.3%) presented an IOFB, 88.9% (n = 8) into the vitreous cavity and 11.1% (n = 1) into the anterior segment. Primary wound closure alone was performed in 81.1% of cases, while combined wound closure and pars plana vitrectomy was performed in 18.9%. Primary globe closure was successful in 91.9% of eyes. 21 eyes (56.8%) required a subsequent PPV after the first surgery (with success rate of 81.0%). Removal of most of IOFBs was performed during the first surgical intervention (66.7% vs. 33.3% during the second). Mean BCVA improved significantly during the follow-up (0.08 ± 0.20 decimals at baseline vs. 0.3 ± 0.41 decimals at the final follow-up; p < 0.05). The most frequent AE was rhegmatogenous RD, that was found in 54.1% (n = 20) of eyes at any time during the follow-up. One eye presented with exogenous endophthalmitis secondary to the open globe injury. Average follow-up time was 28.6 ± 32.8 months (range 12 - 96 months). CONCLUSIONS: In order to preserve the anatomical outcome, globe closure should be performed rapidly. Retinal detachment seems to be the most common complication and may occur months after the trauma. Good anatomical and functional results can be achieved, with appropriate surgical management, even in challenging cases.

Ocular trauma, often resulting in intraocular foreign bodies, presents a formidable challenge for ophthalmologists due to its potential for severe complications.We report a case of a 32-year-old male diagnosed with ocular siderosis secondary to a metallic intraocular foreign body following open ocular trauma sustained 6 months prior.Examination revealed characteristic findings consistent with ocular siderosis, necessitating advanced imaging modalities for confirmation.While initial ultrasound findings were inconclusive, subsequent ultrasonographic biomicroscopy confirmed the presence and location of the foreign body.Surgical intervention was then undertaken to remove the metallic object.This case underscores the significance of comprehensive evaluation and the utilization of advanced imaging techniques in optimizing patient care and outcomes following ocular trauma.

This letter discusses the study by Kılıç et al. on adult open-globe injuries, highlighting its valuable contribution to national data. Several suggestions are presented to enhance the manuscript, including the incorporation of the Ocular Trauma Score (OTS), detailed timing analysis within the first 24 hours, infection prophylaxis clarification, and imaging-based reporting for intraocular foreign bodies. These additions could further strengthen the study’s clinical relevance and interpretability.

To describe a novel technique for the levitation of intraocular foreign bodies (IOFBs) embedded in the vitreous cavity or resting on the surface of the retina. Our novel technique was used on one patient with a metallic IOFB embedded in the vitreous cavity of the left eye following a penetrating injury to that eye. The technique revolves around using the nitinol wire of the Finesse loop® to levitate the IOFB from the vitreous cavity instead of the usual instruments used for that purpose such as External electromagnets (EEM), forceps, rare earth intraocular magnets (IOM). The Patient was followed up for 6 months with routine ophthalmic examinations including dilated fundus examination and fundus imaging. 6 months follow-up of the patient showed stable surgical outcomes with no adverse events related to the used technique. The novel technique for IOFB levitation using the nitinol wire of the Finesse loop® is promising as an easy-to-perform, minimally traumatic alternative to the available techniques especially in cases where magnets cannot be used (eg. Non-metallic IOFBs). Larger samples and longer follow-ups are required to confirm the outcomes of this technique.

Intraocular foreign bodies (IOFBs) constitute a significant public health concern that hinders the accumulation of human capital in countries in Asia. This research aims to identify and project the time trend of the IOFB disease burden in Asia to 2035. We utilised data collected from the Global Health Data Exchange (GHDx) query tool. Time Trends of disability-adjusted life years (DALYs) and incidence of IOFBs were calculated. Age- and gender-specific disease burden of IOFBs in 2019 was also analysed. A Bayesian age-period cohort (BAPC) model with integrated nested Laplace approximations (INLA) was applied to project the number and rate of the disease burden attributable to IOFB from 2020 to 2035. In Asia, the DALYs number increased from 290,521.62 (95% UI: 146,816.5-513,604.1) in 1990 to 388,363.39 (95% UI: 206,296.3-668,164.9) in 2019. The number of DALYs showed an upward trend until the age of 45-49 years, and then decreased in later age groups. The age-standardised incidence rate (ASIR) of China is projected to increase substantially from 719.03 in 2019 to 3127.06 in 2035. Singapore is projected to experience a slight decline, while the remaining six countries are projected to have slight, steady increases in ASIR. Countries in Asia are facing a huge disease burden of IOFB, and ASIRs are projected to increase over the next 15 years in most Asian countries. These findings contribute valuable evidence-based guidance for public health policy in disease prevention, medical planning and resource allocation pertaining to IOFBs in Asia.

Axenfeld loop: Differential diagnosis of intraocular foreign body.

To investigate the opportunistic use of diagnostic focused computed tomography (CT) imaging for differentiating intraocular foreign body (FB) types.From 2020 to 2024, 49 eyes of 41 consecutive patients with a diagnosis of FB who underwent diagnostic focused CT were prospectively included in this study. CT studies of patients who had direct contact with a known FB and those who had indirect contact with an FB and then underwent surgery were examined. The volume and density (in HU) of the FBs were measured and statistically analyzed.The type of foreign body was determined by surgery in 34 patients with indirect injuries and by history in 7 patients with direct injuries. Metal was found in 21 eyes, rock in 8 eyes, bullet core in 10 eyes, wood in 2 eyes, glass in 7 eyes, and plastic in 1 eye. Industrial accidents were the cause in 20 patients, traffic accidents in 6 patients, gunshot injuries in 6 patients, and other types of injuries in 9 patients. 21 left eyes, 15 right eyes, and 5 bilateral eyes were affected. Statistical analyses revealed a significant difference in terms of density (HU) between metal and bullet core, rock-bullet core, wood-bullet core, and glass-bullet core (p<0.05).The majority of intraocular FBs were the result of an industrial accident and were found in the left eye. Bilateral eyes were primarily affected by gunshot injuries. Opportunistic use of CT measurements could accurately differentiate bullet core from metal, glass, stone, wood, or plastic. Left eye protection is particularly important in industrial labor. · Identification of the material in addition to the site is a significant concern for ophthalmologists.. · CT is the method of choice for the imaging of intraocular foreign bodies.. · Beam hardening artifacts accurately differentiate any metal objects and gunshot bullets from other intraocular foreign bodies with a hyperdense appearance.. · Opportunistic use of routine clinical care CT scans by measuring CT densities aids preoperative differentiation of gunshot bullets from other metal objects.. · Erdem Toslak İ, Erol MK, Karagol Aydinyurt G et al. Use of Opportunistic Computed Tomography for Differentiating Intraocular Foreign Bodies. Rofo 2026; DOI 10.1055/a-2781-9014.

To report a case series of intraocular foreign bodies (IOFB) found at unusual sites and their management.This retrospective case series was conducted at the Department of Ophthalmology of Tertiary care centre, over a study period of January 2022 to December 2024. Patients presenting with ocular trauma and diagnosed with intraorbital or intraocular foreign bodies located at unusual anatomical sites were included in the study.Inclusion criteria comprised patients with clinically and radiologically confirmed intraocular or intraorbital foreign bodies who underwent surgical management and had a minimum follow-up of three months. Exclusion criteria included patients with superficial foreign bodies managed conservatively, incomplete medical records, or inadequate follow-up.All patients underwent a comprehensive ophthalmic evaluation, including detailed history, assessment of presenting visual acuity using Snellen’s chart, slit-lamp biomicroscopy, intraocular pressure measurement wherever feasible, and dilated fundus examination. Radiological investigations such as B-scan ultrasonography, X-ray orbit, and computed tomography (CT) scan of the orbit were performed based on clinical suspicion and media clarity. Surgical intervention was planned according to the size, composition, and location of the foreign body, and associated ocular injuries. Patients were followed up postoperatively to assess anatomical integrity, resolution of inflammation, and visual outcomes.Patients were followed up, and all showed significant improvement in vision. This case series highlights the importance of a tailored approach to managing IOFBs based on their size and location.

On 17 September 2024, over 3000 pager devices containing explosives were remotely detonated across Lebanon in a coordinated mass-casualty event, causing unprecedented ocular trauma. This study aims to characterise the nature and extent of ophthalmic injuries treated at a tertiary care centre following this unique attack. A retrospective chart review was conducted of patients presenting to the American University of Beirut Medical Centre on the day of the explosion. Only patients who underwent ophthalmic surgical exploration were included. Data were collected from clinical notes, imaging and operative reports. Injuries were categorised using the Birmingham Eye Trauma Terminology (BETT) classification, and descriptive statistics were applied. 79 patients (158 eyes) underwent surgical exploration. Severe globe trauma was identified in 111 eyes (70.3%), including 61 eyes (55%) with open globe injuries and 50 (45%) with traumatic eviscerations. Bilateral injuries were noted in 45.6% of patients. Intraocular foreign bodies were confirmed in all traumatic eviscerations and 81.9% of open globe injuries. Evisceration was performed in 49 eyes (31%). Adnexal injuries requiring reconstruction occurred in 27.3% of eyes. Among eyes that underwent globe-sparing repair, 71.7% had postoperative visual acuity of no light perception or light perception. This case series describes an unprecedented volume and severity of ocular injuries from a novel blast mechanism. The combination of thermal, chemical and penetrating trauma resulted in high rates of globe loss and poor visual outcomes. Preparedness for future unconventional mass-casualty scenarios must include rapid imaging, specialised ophthalmic teams and coordinated multidisciplinary care.

The T-shaped Scleral Incision Technique as a Recommended Method for Removing Large Intraocular Foreign Bodies: A Case Report of Two Patients

To investigate the preventive effect of intravitreal injection on posterior segment magnetic intraocular foreign body (IOFB)-related endophthalmitis, the risk factors for endophthalmitis, and the prognostic factors of posterior segment magnetic IOFBs. Retrospective analysis of patients with posterior segment magnetic IOFBs admitted to Hebei Eye Hospital (2014-2022). Among them, 172 patients (2016-2022) received intravitreal antibiotics at the time of primary repair. Rates of endophthalmitis in this cohort were compared with those in a previous cohort admitted between 2014 and 2016(56 patients). In the previous cohort, patients received only primary repair. The cohort was predominantly male (94%), median age 39 years. the right eye was affected in 105 patients (45%). The incidence of endophthalmitis was 4.7% (8/172) and 13.6 % (8/59) in the recent and previous cohorts, respectively, with significant difference(P=0.043). Lens capsule rupture and IOFB > 2 mm were risk factors for magnetic IOFB-related endophthalmitis (P=0.024 and P=0.031, respectively). Lens capsule rupture (OR=2.872, 95% CI 1.487-5.548, P=0.002); vitreous hemorrhage(OR=2.010, 95%CI 1.064-3.796, P=0.031); retinal detachment (OR=3.745, 95%CI 1.758-7.979, P<0.001); choroidal detachment (OR=5.109, 95%CI 1.465-17.808, P=0.010) and IOFB>2mm(OR=1.914, 95%CI 1.025-3.574, P=0.042) were predictors of poor visual outcome. Prophylactic intravitreal antibiotics can reduce the incidence of endophthalmitis in posterior segment magnetic IOFB injuries. Lens capsular rupture and IOFB > 2 mm are risk factors for endophthalmitis. In addition, lens capsular rupture, vitreous hemorrhage, retinal detachment, choroidal detachment, and IOFB > 2 mm are associated with a poor prognosis. A good initial VA is associated with a good prognosis.

To evaluate the anatomical and functional outcomes of pars plana vitrectomy (PPV) combined with prophylactic chorioretinectomy (CR) in patients with deadly weapon-related open globe injuries (DWOGIs). Medical records of patients who underwent PPV and prophylactic CR for open globe injuries (OGIs) caused by deadly weapons between November 2016 and October 2024 were retrospectively reviewed. Demographic characteristics, injury type, cause of injury, zone of injury, intraocular foreign body (IOFB) exit/impact site, best-corrected visual acuity (BCVA), proliferative vitreoretinopathy (PVR) rates, anatomical success, and globe survival were evaluated. Of a total of 283 OGIs, 41 eyes from 35 patients who underwent PPV with prophylactic CR for deadly weapon-related trauma were included in the analysis. The mean age was 30.9+-9.4 years, and 88.6% of the patients were male. Perforating injuries were observed in 38 eyes (92.7%), and penetrating injuries associated with an IOFB in 3 eyes (7.3%). The causes of injury included improvised explosive devices in 20 eyes (48.8%), hand grenades in 11 eyes (26.8%), landmines in 8 eyes (19.5%), and rocket-propelled grenades in 2 eyes (4.9%). The IOFB exit/impact site was located in the posterior pole in 38 eyes (92.7%), of which 22 (53.6%) were outside the vascular arcades, 12 (29.3%) within the vascular arcades, and 4 (9.7%) adjacent to the optic disc. The mean initial BCVA was 2.62+-0.98 logMAR, with 90.2% of eyes presenting between light perception and counting fingers. PPV was performed at a mean of 5.9+-2.7 days after primary repair. Of these eyes, 43.9% had retinal detachment. The mean number of PPV procedures was 2.6+-1.1. C3F8 gas endotamponade was used in 51.2% of cases. At a mean follow-up of 32.8+-16.6 months, the final BCVA improved significantly to 1.18+-1.20 logMAR (p<0.001), with 68.3% achieving ≥20/200 vision. At final follow-up, the rates of PVR, anatomical success, and globe survival were 14.6% (6/41), 85.4% (35/41), and 87.8% (36/41), respectively. Pars plana vitrectomy combined with prophylactic CR appears to be an effective treatment option for DWOGIs, offering prevention of PVR development and achieving high anatomical success, favorable globe survival, and meaningful visual improvement despite severe ocular trauma.

Background: Intraocular Foreign Bodies (IOFBs) are one of the common causes of visual loss. Missed IOFBs can lead to devastating complications. Case Report: A 14-year-old boy presented with one-month history of vision loss in the right eye from an electric cable used to whip a cart-horse. He was treated with unspecified eye drops and intravenous antibiotics at peripheral facilities. At a Tertiary hospital, CT scan revealed panophthalmitis and IOFB with orbital extension. He was managed with evisceration and foreign body removal. Conclusion: A high index of suspicion and appropriate investigations help minimize complications in patients with IOFBs.

Penetrating injuries with intraocular foreign bodies (IOFB) remain a major cause of ocular morbidity worldwide. This study aimed to determine the physical and morphometric characteristics of IOFBs and investigate the correlation to the injury pattern. Intraocular foreign bodies retrieved between January 2018 and December 2023 were examined for dimension, weight, shape, and magneticity. In order to classify the shape of the IOFB, various indices were calculated. Clinical records, imaging data, and operative reports were retrospectively analyzed to determine the course of the incident, point of entry, and final intraocular position. Fifty-four IOFBs were removed during the study period. Of these, 39 met the inclusion criteria. The majority of IOFBs were metal and magnetic (n = 32; 82%). Three IOFBs consisted of glass, two were made of wood and 2 eyelashes were extracted. The mean length, width and thickness were 4.95mm, 1.70mm and 0.86mm, respectively. The average weight was 20.49mg (0.2-112mg; SD: 31mg). The final intraocular location of foreign bodies was highly variable. With the exception of one case, all wire-shaped foreign bodies entered through the limbal cornea and penetrated into the suprachoroidal space. The variables of roundness, moment of inertia, length, circumference, and secondary moment of the major axis were identified as significant predictors of penetration depth. In order to break through the corneal or scleral rigidity, foreign bodies must have certain physical properties and sufficient kinetic energy upon impact. Specific foreign body shapes can also lead to specific injury patterns. These precise measurement data may be important for future studies in trauma prevention, materials research, or the development of ophthalmic instruments.

Intraocular foreign bodies (IOFB) remain a significant cause of visual impairment worldwide. The complex nature of IOFB cases poses considerable management challenges, contributing to various outcomes. This study aimed to determine clinical characteristics and prognostic factors associated with visual outcomes following IOFB treatments. We conducted a retrospective review of IOFB patients admitted between January 2019 - January 2024 at a tertiary hospital in Indonesia. Medical records were evaluated based on predefined inclusion and exclusion criteria. A total of forty-six patients (46 eyes) were analyzed, of which 76.1% had metallic IOFBs (35 eyes), predominantly caused by hammering metal (70%). Cornea was the most frequent entry site (31 eyes). The mean preoperative best-corrected visual acuity (BCVA) was 1.74 ± 1.01 (logMAR), improving to 1.28 ± 1.03 at the final follow-up. Univariate analysis showed larger IOFB size, worse initial BCVA, longer injury-to-surgery intervals, higher complications, endophthalmitis, traumatic cataract, secondary glaucoma, and primary surgery with lensectomy were significantly associated with poor final BCVA. Multiple logistic regression identified poor baseline BCVA and the need of additional lensectomy procedure as independent risk factors for lower final BCVA. Lower preoperative BCVA and concomitant lensectomy subsequent to IOFB removal were significant predictors of poor visual prognosis.

To characterize the clinical presentation of intraocular foreign body (IOFB) injury and evaluate the short-term visual acuity outcomes following 25-gauge pars plana vitrectomy (PPV), with identification of independent predictors of postoperative visual recovery. A retrospective study was conducted on 198 patients (198 eyes) diagnosed with IOFB who underwent 25G minimally invasive PPV at the Department of Ophthalmology, First Hospital of Hebei Medical University, between January 1, 2020, and December 31, 2024. Clinical characteristics of the IOFB, therapeutic efficacy of PPV, and best corrected visual acuity (BCVA) were analyzed to identify factors influencing postoperative visual acuity. Furthermore, receiver operating characteristic (ROC) curve analysis was performed to validate the predictive accuracy of the model for postoperative visual outcomes. Among the 198 patients, most were young and middle-aged males residing in rural areas. Metal IOFB were the predominant type, accounting for 141 eyes (71.2%). The majority of these foreign bodies entered through Zone I (157 eyes, 79.3%), with a complete intraoperative removal rate (100%). Preoperatively, BCVA was ≥0.1 in 81 eyes and <0.1 in 117 eyes. Postoperatively, BCVA improved to ≥0.1 in 126 eyes, while it remained below 0.1 in 72 eyes. This improvement in BCVA after surgery was statistically significant (p < 0.001). Multivariate logistic regression analysis revealed that poor preoperative BCVA, macular involvement by the foreign body and coexisting endophthalmitis were independent risk factors for suboptimal postoperative visual outcomes. A composite predictive model integrating these three variables exhibited strong discriminatory performance, with an area under the AUC of 0.797 (95% confidence interval: 0.735-0.859), with a sensitivity of 94.4% and specificity of 55.6%, indicating high predictive accuracy. 25G minimally invasive PPV effectively improves visual acuity in the majority of patients with IOFB. Preoperative poor BCVA, macular impaction of foreign bodies and coexisting endophthalmitis are significant independent risk factors for short-term suboptimal postoperative visual outcomes.

A 38-year-old male, a mechanic by occupation, presented with redness, pain, and irritation in the left eye for the past 2 weeks, with no significant systemic history. The history of ocular trauma 1 year ago was elicited. Following multiple consultations elsewhere, he used topical medications, which led to temporary resolution of symptoms, only to recur on discontinuation of the medications. On examination, the best corrected visual acuity was 6/6 in both eyes. On slit-lamp examination, circumciliary congestion was seen in the left eye, albeit without a conspicuous entry wound. Anterior chamber inflammation was observed with cells 2+ according to Standardised Uveitis Nomenclature (SUN) classification,[1] with a 2 × 2 mm iron foreign body in the inferior angle [Fig. 1a]. Inflammatory adhesions were noted between the foreign body and the anterior surface of the iris, resulting in a corectopia toward the foreign body. Four-mirror gonioscopy revealed a rusted iron foreign body in the inferior angle of the anterior chamber, along with peripheral anterior synechiae [Fig. 1b]. Intraocular pressure and posterior segment examination were unremarkable. B-scan and X-ray orbit ruled out concomitant posterior segment and orbital involvement.Figure 1: (a) Slit-lamp photograph taken using oblique illumination depicts an intraocular rusted iron foreign body camouflaging with the iris at the 5 o’clock hour position with peripheral anterior synechiae and corectopia toward the IOFB. (b) Slit-lamp photograph taken through a four-mirror goniolens portraying the intraocular iron foreign body in the inferior angle of anterior chamber, along with iris adhesionsSurgical removal was performed, wherein two clear corneal incisions were made at 5 o’clock hours, and following synechiolysis, the foreign body was extracted. The postoperative period was uneventful. The patient was discharged on antibiotic and steroid eyedrops, with optimal recovery upon 2-weekly follow-up. Discussion Chronic intraocular ferrous foreign bodies result in a constellation of clinical features called siderosis, depending upon the iron concentration in the foreign body. Following dissociation, iron deposits over the cornea, lens, ciliary body, and/or sensory retina, exerting its toxic effects, causing cell death. Manifestations include corneal staining, anterior subcapsular cataract, pigmentary retinopathy, and subsequent retinal atrophy.[2] Involvement of trabecular meshwork causes secondary open-angle glaucoma, called siderotic glaucoma.[3] Despite such a longstanding history, none of the aforementioned features was seen, except for a protracted anterior chamber inflammatory reaction, likely due to the slow release of iron ions. Two similar cases of retained intraocular foreign bodies without associated siderosis have been reported before.[4,5] Authors' Contributions Dr. Samarth Kacker- Literature search, manuscript preparation, manuscript editing. Dr. Ashwathi Deepak- Literature search, manuscript preparation, manuscript editing. Dr. Sameer Chaudhary- Design, manuscript editing, manuscript review. Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed. Financial support and sponsorship: Nil. Conflicts of interest: There are no conflicts of interest.

To evaluate the structural and functional outcomes of 25-gauge pars plana vitrectomy (PPV) in children with post-traumatic endophthalmitis. This retrospective study included 33 children (mean age: 6.5 ±2.6 years) with endophthalmitis following open globe injury who underwent 25G PPV. Preoperative parameters recorded were age, gender, time of onset, best-corrected visual acuity (BCVA), hypopyon, intraocular foreign body (IOFB), and retinal detachment (RD). Surgical details noted included timing of PPV, intraoperative findings, lens status, tamponade, and need for pars plana lensectomy (PPL). Vitreous samples were taken for microbiology. Minimum follow-up was 3 months. The mean interval between injury and onset of endophthalmitis was 4.72 ±3.75 days, and the mean time to PPV was 5.8 ±4.7 days. Hypopyon was present in 45.4%, IOFB in 12.1%, and RD in 6.1%. PPL was performed in 81% of eyes. Mean preoperative BCVA was 2.6 ±0.2 logMAR, improving significantly to 1.3 ±0.5 logMAR at 3 months (p3/60) was achieved in 33.3%. Anatomical success with retinal attachment was achieved in 72.7%, and endophthalmitis resolution in 90%. Retinal reintervention was required in 15%. Oil tamponade was used in 30% and gas in 9.1%. Microbiological positivity was seen in 39.3%, most commonly Gram-positive cocci. Early 25G PPV in pediatric post-traumatic endophthalmitis offers favorable structural and functional outcomes. High rates of infection resolution and retinal attachment can be achieved despite severe presentation, particularly with timely vitrectomy, tailored tamponade, and lensectomy when indicated.

This study aims to analyze global trends and disparities in the incidence and burden of intraocular foreign bodies (IOFBs) from 1990 to 2021 across 204 countries and territories, stratified by region, age, sex, socio-demographic index (SDI) and human development index (HDI), while assessing the impact of the COVID-19 pandemic. Utilizing data from the Global Burden of Disease Study 2021 (GBD 2021), we extracted the age-standardized incidence rates (ASIR), years lived with disability (YLDs), and the number of cases of IOFBs. Estimated annual percentage changes (EAPC) were calculated to evaluate trends. Globally, the number of IOFB cases increased by 33% (21.59 to 28.67 million) from 1990 to 2021. While ASIR declined overall (EAPC: -0.99), an upward trend emerged post-2010. High-SDI regions and very high HDI countries exhibited the highest ASIR, whereas low-SDI regions saw the largest case growth (129%). Males aged 25-54 years comprised the majority of cases. COVID-19 altered injury patterns, shifting incidents to domestic settings. Regions like East Asia and Brazil demonstrated significant ASIR reductions, while Central Latin America experienced rising trends. Similarly, regions and countries such as East Asia and Brazil showed significant decreases in YLDs rate, while Southeast Asia and the Philippines showed a slight upward trend. Despite the current decline in ASIR from 30 years ago, it has shown an upward trend since 2010, indicating that IOFBs is an ongoing public health challenge. Disparities due to socioeconomic development, occupational risks, demographic factors, and epidemics necessitate targeted interventions. In the future, strengthening occupational regulations, healthcare capacity, and data-driven prevention strategies appear quite necessary.

Background: Among ocular injuries, corneal foreign bodies (FBs) are the most reported in clinical practice. Superficial FBs are easily visualized using slit-lamp biomicroscopy and can often be removed immediately as an outpatient procedure. [1] In children and uncooperative patients where the exact location and depth cannot be commented on slit-lamp examination, anterior segment optical coherence tomography (AS-OCT) plays a critical role in evaluating FB depth, location, and possibility of Descemet’s membrane (DM) breach. [2] Purpose: A depth-based surgical technique facilitates precise management, maintaining corneal structural integrity and reducing the likelihood of postoperative complications. Synopsis: This video explores the clinical challenges associated with the removal of various intraocular foreign bodies via the anterior approach. Through case-based clinical scenarios, it illustrates depth-based surgical planning and various FB removal techniques and highlights the role of AS-OCT in guiding surgical decisions. Postoperative outcomes are also discussed, emphasizing the importance of precise preoperative assessment and technique selection. Highlights: This video highlights a detailed overview of various intraocular FB (IOFB) management techniques, emphasizing individualized approaches based on FB characteristics and tissue response. Organic FBs pose a high risk of infection and necessitate prompt removal. In contrast, inert materials are usually well tolerated, while metallic FBs can trigger inflammation and require vigilant follow-up. [3] AS-OCT plays a vital role in surgical planning by delineating entry tracts and evaluating the integrity of DM. [2,4] Superficial FBs limited to the anterior stroma are typically removed externally. However, when an FB breaches the DM, removal via the anterior chamber using long vitreoretinal forceps is preferred. [5] This internal approach provides better surgical access, preserves corneal architecture, and minimizes the risk of enlarging the entry tract or inducing astigmatism. Video Link: https://youtu.be/SBH0Aa9kj7c