Bullous Keratopathy Secondary to Anterior Chamber Angle Foreign Body

Abstract

BACKGROUND: Penetrating ocular trauma with intraocular foreign body is a serious injury often resulting in loss of vision. Anterior chamber foreign bodies account for a considerable portion of all cases of all intraocular foreign bodies (up to 15%); however, they can be missed due to inconspicuous location.
 CASE REPORT: We report two cases of retained intraocular foreign bodies in the iridocorneal angle that was missed at the first ophthalmic examination. They were only discovered when complications occurred, such as corneal edema and increased intraocular pressure. In the case whereby the foreign body was taken out early, corneal damages were reversible. However, in the case whereby the foreign body was taken out late, endothelial damage was irreversible and endothelial transplantation was needed.
 CONCLUSION: Regarding trauma patients, a careful examination should be performed to discover foreign bodies in the iridocorneal angle. If local peripheral corneal edema occurred, attention should be paid to the trauma history and to timely discovery of the foreign body. This will prevent any irreversible corneal damages.

Intraocular foreign body in the anterior chamber angle misdiagnosed as herpetic stromal keratitis

“…[ 5 ] Patients with IOFBs may also present with chronic uveitis[ 6 ] or bullous keratopathy. [ 7 ] Similar to our present case, a previous report described that an IOFB may also masquerade as herpetic stromal keratitis. [ 8 ]…”

“…[5] Patients with IOFBs may also present with chronic uveitis [6] or bullous keratopathy. [7] Similar to our present case, a previous report described that an IOFB may also masquerade as herpetic stromal keratitis . [8] When asymptomatic, IOFBs may be easily overlooked and retained for several years before the onset of these complications.…”

“…[2] This report emphasizes the importance of suspecting and ruling out IOFBs in patients presenting with unilateral corneal edema and anterior lens capsule opacification, particularly in patients engaged in high-risk activity. [7,8,10] In addition, fundamental principles when evaluating potential IOFBs were highlighted. Comprehensive ophthalmologic examination including gonioscopy and CT should be performed to avoid missed IOFBs, undetected by slit-lamp examination.…”