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[Delayed loss of vision after hammer and chisel injury].

Authors :
Schnaidt AG
Schröder AC
Gatzioufas Z
Löw U
Lang HM
Seitz B
Source :
Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft [Ophthalmologe] 2009 Nov; Vol. 106 (11), pp. 1017-21.
Publication Year :
2009

Abstract

Eye injuries caused by foreign bodies are a common diagnosis in many patients with an ocular emergency. A high percentage of foreign bodies are located in the cornea and are easily removed, but an intralenticular foreign body after eye injury is very rare. A 28-year-old man referred to our department with increasing loss of vision in the right eye 1 month after an accident with a hammer and chisel. At the time of admission the patient complained of a significant loss of vision and a traumatic cataract was diagnosed. The examination showed a deep stromal corneal scar and an anterior subcapsular cataract with posterior contusional rosette. Slit-lamp examination in mydriasis aroused the suspicion of an intralenticular foreign body. An X-ray examination of the right orbit was performed, but apart from a shadow, which was interpreted by the radiologists as a "pixel artefact", it revealed no presence of a foreign body. A computed tomography examination was also undertaken and confirmed the suspicion of an intralenticular foreign body, which was confirmed by an ultrasound scan. The intralenticular foreign body was removed during cataract surgery and an IOL was successfully implanted in the intact capsular bay. The day after the surgical intervention BCVA was 1.0. Every ocular trauma with a foreign body should be examined in mydriasis in order to exclude an intralenticular foreign body. Conventional X-ray images may not always be efficient enough to detect a foreign body. If an intraocular foreign body is suspected a thin-slice computed tomography examination of the orbit should be performed.

Details

Language :
German
ISSN :
1433-0423
Volume :
106
Issue :
11
Database :
MEDLINE
Journal :
Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
Publication Type :
Academic Journal
Accession number :
19504111
Full Text :
https://doi.org/10.1007/s00347-009-1955-8