Image of the Month - August 2021
A woman in her 50s presented with floaters in the right eye after chiseling cement without eye protection. Visual acuity was 20/25-2 in the right eye and 20/20 in the left eye. Intraocular pressure was 18 mm Hg in the right eye and 17 mm Hg in the left eye. An external photograph of the right eye showed a small corneal laceration in addition to a defect on the anterior lens capsule and cataract (A). Anterior segment optical coherence tomography showed a focal full-thickness corneal irregularity (B). Widefield fundus imaging (C) demonstrated a small tear- shaped intraocular foreign body in the vitreous cavity and fundus autofluorescence (D) highlighted the retinal impact site. Both images were blurred over the macula secondary to media opacity from the cataract. The patient was diagnosed with metallic intraocular foreign body with a self-sealing corneal laceration and traumatic cataract. The patient underwent urgent lens sparing pars plana vitrectomy for intraocular foreign body removal on the day of presentation and has recovered well with an attached retina and a mild traumatic cataract.
Cowritten by Natalie Huang, MD PGY4