Intralenticular Metallic Foreign Body After Pediatric Ocular Trauma

Intraocular foreign bodies penetrating the eye can lead to serious complications, including endophthalmitis, and therefore require urgent removal. We present the case of a 9-year-old boy with an intraocular foreign body lodged in the lens with a corneal flap wound. The injury occurred while hammering a bicycle frame. The patient presented with sudden pain, tearing, and decreased visual acuity in the left eye. On admission, the left eye distance best-corrected visual acuity (BCVA) was 0.4 and intraocular pressure (IOP) was 17 mmHg. Slit-lamp examination of the left eye revealed a full-thickness corneal flap wound, a traumatic cataract, and a foreign body located centrally within the lens. B-scan ultrasonography demonstrated an echogenic focus within the lens consistent with an intralenticular metallic foreign body, with a normal posterior segment, a regular appearance of the optic disc, and an attached retina. The patient underwent phacoaspiration of the traumatic cataract with intraocular lens implantation and simultaneous removal of the foreign body. Given the corneal flap wound located in the visual axis and the absence of ocular hypotony, the decision was made not to place a corneal suture. At discharge, BCVA improved to 1.0, with IOP of 17 mmHg and normal fundus appearance.