Summary about Disease
An intraocular foreign body (IOFB) refers to any object that penetrates the eye and remains lodged inside. These objects can range from small metallic fragments (e.g., from hammering or grinding) to larger pieces of glass or wood. IOFBs are a serious ocular injury that can lead to vision loss through direct trauma, infection (endophthalmitis), inflammation, and retinal detachment. Prompt diagnosis and management are crucial for preserving vision.
Symptoms
Symptoms vary depending on the size, location, and composition of the foreign body, as well as the extent of the damage. Common symptoms include:
Sudden eye pain
Blurred vision or decreased vision
Redness and inflammation of the eye
Tearing
Sensation of something in the eye
Visible foreign body on the eye surface or within the eye
Pupil abnormalities
Bleeding in the eye (hyphema)
Light sensitivity (photophobia)
Causes
IOFBs are typically caused by penetrating injuries from:
High-speed projectiles from hammering, grinding, or drilling
Explosions or accidents involving sharp objects
Workplace accidents (e.g., construction, manufacturing)
Sports-related injuries (less common)
Assaults
Medicine Used
Medical treatment often involves:
Topical Antibiotics: To prevent superficial infection.
Systemic Antibiotics: Intravenous antibiotics are commonly used to prevent or treat endophthalmitis (a severe intraocular infection). Common examples include vancomycin and ceftazidime.
Topical Steroids: To reduce inflammation.
Pain medication: For pain management.
Tetanus prophylaxis: If indicated based on vaccination history.
Antifungal medication: If a fungal infection is suspected. Surgical intervention is almost always required to remove the foreign body and repair the damage.
Is Communicable
No, an intraocular foreign body is not communicable. It is a traumatic injury caused by an external object entering the eye, not an infectious disease.
Precautions
Preventive measures are key:
Wear appropriate eye protection: Safety glasses or goggles are essential during activities that pose a risk of eye injury, such as hammering, grinding, drilling, or working with machinery.
Maintain equipment properly: Ensure that tools and machinery are in good working order and that safety guards are in place.
Be aware of surroundings: Pay attention to potential hazards in the environment.
Promptly seek medical attention: If you suspect that you have an IOFB, seek immediate medical attention. Do not attempt to remove the object yourself.
Avoid rubbing the eye: Rubbing can worsen the injury.
Shield the eye: Use a protective shield to prevent further trauma.
How long does an outbreak last?
There is no "outbreak" associated with intraocular foreign bodies. It is an individual injury, not a contagious disease. The "duration" relates to the healing time, which depends on the severity of the injury, the type of foreign body, and the success of treatment. Healing can take weeks to months.
How is it diagnosed?
Diagnosis typically involves:
Visual acuity testing: To assess the extent of vision loss.
Slit-lamp examination: A detailed examination of the eye using a microscope.
Fundus examination: Examination of the back of the eye (retina and optic nerve).
Imaging studies:
X-ray: To detect metallic foreign bodies.
CT scan: More sensitive than X-ray for detecting metallic and non-metallic foreign bodies and determining their location.
Ultrasound: Can be helpful if the view into the eye is obscured by bleeding or inflammation.
Gonioscopy: Examination of the drainage angle of the eye.
Electroretinography (ERG): Tests the function of the retina, especially if there is concern about retinal damage.
Timeline of Symptoms
Immediate: Sudden pain, redness, tearing, blurred vision.
Within hours: Inflammation, potential bleeding, light sensitivity.
Days to weeks: Risk of infection (endophthalmitis), retinal detachment, cataract formation, glaucoma. Symptoms will worsen without treatment.
Important Considerations
Endophthalmitis: Prevention and early treatment of endophthalmitis are critical.
Retinal detachment: This is a serious complication that can lead to permanent vision loss.
Surgical planning: Careful surgical planning is essential to minimize further damage to the eye.
Prognosis: The prognosis depends on the size, location, and composition of the foreign body, as well as the promptness and effectiveness of treatment.
Medico-legal aspects: IOFB injuries often involve workplace accidents, so documentation and reporting are important.
Psychological impact: The injury can be traumatic, and patients may require psychological support.