International Journal of Critical Illness and Injury Science

LETTER TO THE EDITOR
Year
: 2014  |  Volume : 4  |  Issue : 3  |  Page : 272--273

A case of treatment-resistant uveitis with intraocular foreign body


Ali Akal1, Tugba Goncu1, Mustafa Atas2, Suleyman Demircan2, Ufuk Ozkan1, Isa Yuvaci1,  
1 Department of Ophthalmology, School of Medicine, Harran University, Sanliurfa, Turkey
2 Department of Ophthalmology, Kayseri Training and Research Hospital, Kayseri, Turkey

Correspondence Address:
Ali Akal
Department of Ophthalmology, School of Medicine, Harran University,Sanliurfa
Turkey




How to cite this article:
Akal A, Goncu T, Atas M, Demircan S, Ozkan U, Yuvaci I. A case of treatment-resistant uveitis with intraocular foreign body.Int J Crit Illn Inj Sci 2014;4:272-273


How to cite this URL:
Akal A, Goncu T, Atas M, Demircan S, Ozkan U, Yuvaci I. A case of treatment-resistant uveitis with intraocular foreign body. Int J Crit Illn Inj Sci [serial online] 2014 [cited 2020 Jan 18 ];4:272-273
Available from: http://www.ijciis.org/text.asp?2014/4/3/272/141492


Full Text

Dear Editor,

Foreign objects can cause ocular damage in two major ways. First, they cause penetrating injuries and related complications, and the other caused by a foreign body infection, toxicity, and damage is caused by an inflammatory reaction. [1],[2] The purpose of presenting this case is to draw attention to intraocular foreign body research at patients showing no evidence of trauma disrupts the integrity of the globe, the lens subcapsular epithelial pigmentation levels in patients not responding to medical therapy.

An 18-year-old male patient with symptoms of blurred vision in the left eye for 1 month applied to eye clinic. The patient was taking intense treatment as a systemic and topical corticosteroid. All investigations were performed regarding the etiology of uveitis systemic. The etiology of uveitis could not be determined. In the patient history was working at the industrial zone, there was no history of trauma at eye and any systemic disease. In the eye examination, right eye to see 10/10, left eye see was at the level of hand movements. Intraocular pressures of the left and right eye were 9 and 6 mm Hg, respectively. Right eye was normal in fundus examination, left eye was not clearly evaluated due to the intense vitritis. At the slit-lamp biomicroscope examination, right eye findings were normal, there was not deep and superficial conjunctival hyperemia in the left eye examination. Intense pigment in the anterior chamber, flaire, subcapsular lens pigmentation at epithelial level was present [Figure 1]. Two-way head radiograph was asked from the patient. Intraocular foreign body was not detected due to superposition [Figure 2]. Metallic foreign body was detected at orbital computed tomography of intraocular 2.2 × 2.0 mm in size [Figure 3]. Intraocular foreign body was removed with 20G pars plana vitrectomy. Cataract extraction and intraocular lens implantation were performed in the same session. Postoperative intraocular pressure increased and YAG-laser iridotomy was done. Intraocular pressure was normal during follow-up. Vision in the left eye at the end of a 1-year follow-up of level was 1/10 level.{Figure 1}{Figure 2}{Figure 3}

In our patient, there was uveitis refractory to medical treatment. On examination, there was no evidence of foreign body in place. First, two-way head radiographs were asked from the patient to investigate the intraocular foreign body. Due to the nonvisualization of foreign body with the probability of bone superposition, orbital bone computed tomography was requested. At the tomography there was foreign body in the left eye. In the presence of the intraocular foreign body, surgery action should be planned according to the duration of exposure, on the nature, size, whether or not encapsulated, rather than in retinal toxicity. At patients with foreign bodies preserved and vision is clear, to follow the patient with taking into account the risks of surgery is preferable. [3],[4] In our case, due to the level of vision at hand movements and intense metallic foreign body with posterior uveitis, emergency pars plana vitrectomy was planned and performed. The foreign body was removed with forceps by preventing to drop it into the retina after implemented vitrectomy. As a result, intraocular foreign body should be kept in mind that in spite of medical treatment at a young age to relax in uveitis patients without evidence of any foreign body in the place of entry.

References

1Vatavuk Z, Pentz A. Combined clear cornea phacoemulsification, vitrectomy, foreign body extraction, and intraocular lens implantation. Croat Med J 2004:45:295-8.
2Hasanreisoðlu B. In: Turaçlý E, editor. Eye traumas, 7 th Ophthalmology course; 1987. p. 133 -43.
3Mester V, Kuhn F. Ferrous intraocular foreign bodies retained in the posterior segment: Management options and results. Int Ophthalmol 1998:22:355-62.
4Soheilian M, Feghi M, Yazdani S, Anisian A, Ahmadieh H, Dehghan MH, et al. Surgical managementof non-metallic and non-magnetic metallic intraocular foreign bodies. Ophthalmic Surg Lasers Imaging 2005:36:189-96