Open Globe Injury Case Report

Abstract

Purpose:To report three cases of open globe injury with large (>5mm) metallic foreign bodies and crystalline lens involvement with good visual and anatomic outcome

Case Reports: Patient 1 was a 47-year-old man who presented with 20/200 visual acuity and a wire passing full-thickness through the central cornea and crystalline lens into the vitreous of the right eye. Patient 2 was a 47-year-old man who presented with hand motions vision, a limbal globe rupture, and a traumatic cataract in the left eye. He was found on imaging to have a nail within the crystalline lens, causing a peripheral retinal hole. Patient 3 was a 43-year-old man who presented with 20/30 visual acuity and a metal bristle embedded full-thickness through the paracentral cornea and violating the

All patients underwent primary closure of the open globe injury within 24 hours; delayed closure is another known risk factor for endophthalmitis and poor visual outcome.3The mechanism of injury, penetrating trauma, as opposed to blunt trauma, is also associated with better prognosis.2Hammering, cutting, and welding metal as a mechanism of open globe injury all convey a higher risk of a concurrent IOFB.11On the other hand, Greven et al found in a large series that hammering metal as the mechanism of IOFB actually was associated with superior visual acuity outcomes.9Similarly, Valmaggia et al reported a large series of posterior segment metallic IOFBs from hammering in which more than 80% of patients had final visual acuity of 20/40 or better.12A final factor was the location of entry wound. All three cases featured primarily zone 1 injuries, involving only the cornea and limbus, as defined by the Ocular Trauma Classification Group.1Zone 1 injury carries a better prognosis than either zone 2 (limbus to 5mm posterior into sclera) or zone 3 (posterior to 5mm from the