Corneal Metallic Foreign Body Injuries Due To Suboptimal Ocular Protection

Abstract

Retrospective review of 100 consecutive presentations of metallic corneal foreign body to the Royal Victorian Eye and Ear Hospital emergency department was undertaken between November and December 2009. The majority of the patients (97%) were male with a mean age of 42 ± 13 years (range 19-73 years). The most common mode of injury was grinding (88%). Nearly half (45%) of patients were wearing "safety eye wear" at the time of injury. Combination of 25-gauge needle and burr was the commonest method employed for removal of foreign body. Overall, 88% (n = 88) cases healed with corneal scar at the site of corneal foreign body and 1 case developed bacterial keratitis. Metallic corneal foreign bodies are common presentations to the emergency department and may be related to inadequate implementation of occupational safety measures.

Metallic corneal foreign bodies: an occupational health hazard

“…Occupational injury by corneal FB comprises 35%58% of all ocular trauma (9,10) , and more frequently affects young men (11) . These preventable injuries cause additional bur den on the national economy, adjustment problems, and psycho logical morbidity (5,12) .…”

“…Despite wearing goggles, 43% patients sustained injuries. In a similar study, 45% patients sustained an eye injury while wearing some form of eye protection (11) . In this context, new designs should be implemented and workplace standards should be adjusted to increase the protecti ve capabilities of goggles (7) .…”

“…In one of our patients, a deep corneal scar caused vision loss that resulted from a corneal abscess that formed after selfremoval of an FB. In an Australian study that included 100 patients with metallic corneal FBs, one patient presented with bacterial keratitis, although it was not indicated whether the patient attempted FB removal (11) . Metallic FBs usually leaves a rust ring in the cornea often causes a white scar to form that can decrease visual quality.…”

Metal Workers with Corneal Injuries and Abuse of Topical Drugs

“…A study reported the frequency of CFBI among metal workers in Turkey as being 37% (8). Secondary infection may also develop due to CFBI, ranging from keratitis to endopthalmitis (9). Vision loss may develop because of scar development at the visual axis (5).…”

“…CFBI is an ophtalmological emergency, and the foreign body must be removed from the cornea with a 25-gauge needle in a non-traumatic fasion. Postoperative proliferative antibiotic treatment has also been administered (9).…”