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PHOTO ESSAY
Year : 2022  |  Volume : 2  |  Issue : 4  |  Page : 988-989

Retained intra-ocular foreign body in the anterior chamber angle


1 Department of Glaucoma, Aravind Eye Hospital, Coimbatore, Tamil Nadu, India
2 Department of Cornea, Aravind Eye Hospital, Coimbatore, Tamil Nadu, India

Date of Submission27-Feb-2022
Date of Acceptance11-Jul-2022
Date of Web Publication11-Oct-2022

Correspondence Address:
Dr. Premanand Chandran
Aravind Eye Hospital, Avinashi Road, Coimbatore 641 014, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_547_22

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  Abstract 


Keywords: Angle foreign body, intra-ocular foreign body, penetrating injury


How to cite this article:
Chandran P, Thilagar SP, Vijayaraghavan P. Retained intra-ocular foreign body in the anterior chamber angle. Indian J Ophthalmol Case Rep 2022;2:988-9

How to cite this URL:
Chandran P, Thilagar SP, Vijayaraghavan P. Retained intra-ocular foreign body in the anterior chamber angle. Indian J Ophthalmol Case Rep [serial online] 2022 [cited 2022 Nov 30];2:988-9. Available from: https://www.ijoreports.in/text.asp?2022/2/4/988/358175



A 53-year-old male presented with defective vision and pain in the right eye (RE) for a month. The patient gave a history of trauma to the RE while cutting stone prior to the development of symptoms. He was treated with topical antibiotics and steroids and referred for corneal de-compensation. His best corrected visual acuity was 6/24 in the RE and 6/6 in the left eye (LE). Slit-lamp examination of the RE showed conjunctival congestion and full thickness corneal scar at 7-o'clock in the paracentral area with surrounding edema involving the inferior cornea [Figure 1]a and [Figure 1]b. The anterior chamber was deep with a normal color and pattern of the iris and a clear lens. Seidel's test was negative. His intra-ocular pressure (IOP) was 12 and 14 mmHg in the RE and LE, respectively. Gonioscopy showed an open angle with a foreign body in the inferior angle of RE [Figure 1]c without hyphema. Posterior segment examination was within normal limits in both eyes. The patient underwent removal of the foreign body under local anesthesia. Temporal clear corneal incision was made with the help of a 15° sideport blade. A viscoelastic was injected to deepen the anterior chamber. A Swan Jacob goniolens was used to visualize the foreign body, which was removed with Utrata capsulorhexis forceps [Figure 1]d. At 1 month, corneal edema resolved, the visual acuity improved to 6/9, IOP was 14 mm Hg with a normal posterior segment, and gonioscopy showed open angles without synechiae.
Figure 1: Slit-lamp photograph showing a localized corneal edema involving the inferior half (a) and self-sealed full thickness scar in the cornea (arrowhead) (b). Gonioscopy showing a foreign body in the inferior angle (c). Foreign body after removal (d)

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  Discussion Top


Intra-ocular foreign bodies have been reported between 18% and 41% of open globe injuries.[1] The anterior chamber angle foreign body constitutes 2% of the intra-ocular foreign body.[2] The patient had a penetrating injury with full thickness corneal scar and inferior corneal de-compensation which arouse the suspicion of a foreign body in the anterior chamber angle. The foreign body in the anterior chamber angle can lead to peripheral corneal endothelial damage and localized corneal edema in the initial stage, which can progress to corneal de-compensation if not diagnosed and treated appropriately.[3] The patient underwent only foreign body removal as there were reports suggestive of complete resolution of corneal edema after removal of the foreign body alone.[4],[5]

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.



 
  References Top

1.
Loporchio D, Mukkamala L, Gorukanti K, Zarbin M, Langer P, Bhagat N. Intraocular foreign bodies: A review. Surv Ophthalmol 2016;61:582-96.  Back to cited text no. 1
    
2.
Behrens-Baumann W, Praetorius G. Intraocular foreign bodies. 297 consecutive cases. Ophthalmologica 1989;198:84-8.  Back to cited text no. 2
    
3.
Dong PN, Duong NTN, Cung LX, Huong DNV, Ngan ND, Thien CD, et al. Bullous keratopathy secondary to anterior chamber angle foreign body. Open Access Maced J Med Sci 2019;7:4311-5.  Back to cited text no. 3
    
4.
Saar I, Raniel J, Neumann E. Recurrent corneal oedema following late migration of intraocular glass. Br J Ophthalmol 1991;75:188-9.  Back to cited text no. 4
    
5.
Segi A, Thilagar SP, Chandran P. Inert angle foreign body with late manifestation. Indian J Ophthalmol 2019;67:1340.  Back to cited text no. 5
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