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Symptoms of eye wounds with foreign body embedding
Last reviewed: 04.07.2025
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If there is a suspicion of a foreign body entering the eye, the anamnesis - data on the injury and the possible composition of the foreign body and even its location - are of great importance.
When a fragment passes through the sclera beyond the part of the eye visible during examination, the entry hole in the cornea and sclera is not visible.
In case of significant corneal wounds, the anterior chamber may be absent, and hemorrhages into the anterior chamber are observed. If the fragment penetrated the eye eccentrically, then biomicroscopy reveals a hole in the iris. In case of a central wound, the hole in the iris may be absent, but then there is a lens injury.
When a foreign body penetrates the lens, a traumatic cataract is determined. The clouding of the lens can be of varying intensity: from complete with the loss of lens masses into the anterior chamber, to partial, posterior helioid cataract. Hemorrhages into the vitreous body of varying intensity are more often observed with trauma to the ciliary body or choroid by a foreign body. When a large foreign body penetrates, a gaping wound of the cornea and sclera with loss of the choroid and vitreous body is clinically determined.
During biomicroscopic examination, a foreign body is sometimes detected in the anterior chamber, lens, or vitreous body. If ophthalmoscopy (transparent lens) is possible, the foreign body can be seen in the vitreous body or on the fundus. If the fragment is not visible, the following clinical signs can help in its diagnosis:
- the presence of a penetrating wound in the wall of the eye;
- detection of a wound cord in the cornea, iris and lens;
- discrepancy between the size of the wound and visual acuity; significant decrease in vision with a minor eye wound;
- damage to the iris and lens, blood in the anterior chamber, hemorrhage into the vitreous body;
- purulent exudate in the anterior chamber;
- air bubbles in the vitreous body during the first day after injury;
- deep anterior chamber and hypotension;
- iritis or iridocyclitis in patients whose profession suggests the possibility of eye damage by a foreign body;
- unilateral mydriasis 3-6 weeks after injury;
- local or total endothelial-epithelial dystrophy of the cornea with the fragment localized in the iridocorneal angle.
When deciding on the removal of a foreign body from the eye, it is necessary to have data on the duration of the fragment’s presence in the eye, its nature, location, size, and associated complications.
If metal fragments for some reason are not removed from the eyes, they gradually oxidize and form compounds that are toxic to the eye tissues, especially the lens and retina. If iron-containing foreign bodies are in the eye for a long time (from 1 month to 3 years), siderosis develops; if copper-containing, chalcosis develops.
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