Diagnosis of X-ray negative intraocular foreign bodies

The paper is focused on diagnosis of X-ray negative intraocular foreign bodies (IOFB) made of wood, plastic, and glass that require a special diagnostic technique. The main IOFB imaging methods (computed tomography [CT], considered as the "gold standard" of diagnosis, magnetic resonance imaging [MRI], ultrasonography [US] and radiography) are addressed. Although CT provides high sensitivity (up to 100% for metals) due to slice thickness (from 0.5 mm), it is less efficient to detect wooden and plastic IOFB. In these cases, CT should be combined with MRI and US. Even as MRI is an efficient method to detect organic materials, absence of metallic IOFB should be confirmed before a start of the investigation. US is a versatile technique, but it depends on a physician's skills and its application is limited in persons with open eye injuries. As radiography yields little information, it is used in the absence of CT only. As for the clinical case report, radiography and US failed to detect an IOFB in a patient with a penetrating eye injury. Nevertheless, it was revealed by CT. Vitrectomy followed by exploration of the vitreal cavity provided IOFB removal and appropriate retinal adaptation. The clinical case report highlights a need for a comprehensive diagnostic technique with a priority of CT combined with MRI and US to detect non-metallic IOFB. KEYWORDS: eye injury, intraocular foreign body, computed tomography, radiography, magnetic resonance imaging, ultrasonography. FOR CITATION: Chernakov A.S., Arzhimatova G.Sh., Rumiantsev A.D., Ryazantsev N.S. Diagnosis of X-ray negative intraocular foreign bodies. Russian Journal of Clinical Ophthalmology. 2025;25(2):124–130 (in Russ.). DOI: 10.32364/2311-7729-2025-25-2-7