Iron in the Eye-Ocular Siderosis due to Intraocular Foreign Body

Abstract

Background: Ocular siderosis is a rare condition in which pigmentary and degenerative changes can occur in the eye due to a retained iron-containing intraocular foreign body. In this case study, we present a case of devastating sequelae of a retained intraocular foreign body and the positive visual outcome following its removal.
Case Report: A 32-year-old male presented to the clinic with chief complaints of floaters and a diminution of vision in the left eye for 2 months. The patient had a history of trauma to the left eye with an iron particle 3 years back, for which he took some local treatment. On ocular examination, the anterior segment of the right eye was within normal limits with visual acuity of 6/6 and projection of rays accurate in all quadrants, while the visual acuity of the left eye was finger counting close to face with projection of rays inaccurate in the nasal quadrant. There was a linear inferonasal corneal opacity (2x1 mm in size) with an iris hole of the same dimensions at the 8 o’clock position of the left eye 2 mm from the limbus in the left eye. There was yellow-brown pigment deposition on the lens capsule with broken posterior synechiae of 5 clock hours, from 4’ o clock to 9 o’clock in the left eye. On USG, old vitreous hemorrhage was seen in the left eye and CECT revealed a foreign body of size 3.2 x 2.8 mm in size in the left eye. The patient underwent cataract extraction and PPV followed by removal of the iron particle using a 20 G magnet, IOL implantation and cryopexy in the left eye. Postoperative best corrected visual acuity of the patient in the left eye was 6/18.
Conclusion: This case emphasizes the importance of conducting a detailed investigation, especially in the working-age population and those in occupations where penetrating injuries cause retention of intraocular foreign bodies. Prompt diagnosis and early intervention can help in achieving a favorable visual outcome.