Siderosis bulbi as a consequence of a missed intraocular foreign body

Abstract

We present a case of a 56-year-old man who suffered an injury to his right eye in June 2012. He presented to an emergency department, however, the presence of a penetrating injury and an intraocular foreign body was not identified. A year later he was referred to the ophthalmology department due to reduced vision and change of iris colour in the same eye. Examination revealed clinical signs consistent with a previous penetrating injury and a retained ferrous intraocular foreign body.

Severe Self-Inflicted Acute Ocular Siderosis Caused by an Iron Tablet in the Conjunctival Fornix

“…Cell death results from the toxic effect of iron on cellular enzyme systems (2,4). The condition may appear from few days up to many years following the injury and any ocular tissue from the cornea to the optic nerve may be affected (2,3). The clinical severity depends on the size and shape of the IOFB, its iron content and the time it remains in the eye.…”

“…The most common manifestations are cataract formation (especially anterior subcapsular), diffuse pigmentary changes of the retinal pigment epithelium, iris heterochromia often in conjunction with a tonically dilated pupil, secondary glaucoma, iritis and cystoid macular edema (4). Retinal arteriolar attenuation, proliferative vitreoretinopathy and retinal detachment have also been described (2,3,4).…”

Siderosis bulbi resulting from an intraocular metalic foreign body: case report

“…A plain orbital X-ray is the recommended imaging for detection of an intraocular foreign body, but if negative a computed tomography scan is then performed. 8 Magnetic resonance imaging is very sensitive in detecting foreign bodies, however, is limited because of the threat of a magnetic object's movement during the test, which can cause more damage. Loss of vision is usually owing to retinal degeneration.…”

Heterocromia de íris: uma revisão das condições que podem afetar a pigmentação iridiana

“…Essa doença afeta principalmente jovens que trabalham em indústrias com manuseio de materiais de ferro, nas quais podem ocorrer traumas oculares em que fragmentos de metais penetram o olho com grande afinidade por superfícies epiteliais, afetando principalmente íris, epitélio não pigmentado ciliar, lente e epitélio pigmentar da retina. (54,55) A siderose ocorre por depósito de agregados de partículas de ferritina aderidas em corpos densos ligados à membrana intracitoplasmática (siderossomos) nas células epiteliais do olho. (56,57) A ferritina cursa com degeneração vacuolar, e os depósitos de ferro alteram a cor da íris, resultando na heterocromia.…”