Intraocular Foreign Body (IOFB)

Updated: Jan 15, 2023
  • Author: Ferenc Kuhn, MD, PhD; Chief Editor: Inci Irak Dersu, MD, MPH  more...
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Overview

Background

Intraocular foreign bodies (IOFBs) are rather variable in presentation, outcome, and prognosis. With increased awareness and advanced surgical techniques, the outcome and the prognosis for these potentially devastating injuries have substantially improved. [1]

The most important limiting factor today is the damage occurring at the time of the initial injury. One effective method appears to be prophylactic chorioretinectomy (see Surgical Care), which reduces the risk for postinjury proliferative vitreoretinopathy (PVR).

Metal intraocular foreign body located in the left Metal intraocular foreign body located in the left temporal pars plana region seen on axial CT scan.
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Pathophysiology

The final resting place of and damage caused by an IOFB depend on several factors, including the size, the shape, and the momentum of the object at the time of impact, as well as the site of ocular penetration. [2, 3]

IOFBs transversing the lens are less likely to cause major retinal damage; conversely, a smaller wound size usually means deeper penetration.

In addition to the initial damage caused at the time of impact, the risk for endophthalmitis and subsequent scarring (eg, PVR) play an important role in the planning of the surgical intervention. [4]

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Epidemiology

Frequency

United States

The incidence of ocular injuries in the United States is 2.4 million cases. Intraocular foreign bodies make up 17-41% of open globe injuries. [1]

The most common occupations in which IOFBs occur are workers and farmers, because people in those occupations do a great deal of hammering, drilling, chiseling, and shoveling. Only 13% of IOFB injuries are experienced during home-related work. [1]

International

The frequency greatly varies (18-41%) worldwide, depending upon the population surveyed. [5]

Mortality/Morbidity

Most IOFBs cause internal damage, and most will come to rest in the posterior segment. Commonly injured structures include the cornea, the lens, and the retina.

Race

No racial predilection has been found so far.

Sex

Most patients with IOFBs are male. [1]

Age

Most individuals with IOFBs are young and male. [1]

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Prognosis

Factors that influence visual prognosis include size, site, composition of the foreign body, inflammatory response, tissue damage, time since injury, and presence of any associated endophthalmitis and retinal detachment. [1]

 

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