Open globe ocular trauma with penetrating corneal wound and intraocular foreign body. Case report from Bolivia.

Résumé fourni par la source

Introduction: Open globe trauma with an intraocular foreign body constitutes an ophthalmological emergency that irreversibly threatens vision. Its prognosis depends on the location of the injury, the structures involved, and the speed of treatment. Case report: A 34-year-old male patient, with no relevant medical history, presented with right ocular trauma from a metallic foreign body, eight hours prior, with intense pain, tearing, and sudden vision loss. Biomicroscopy revealed a 4 mm penetrating corneal wound, a positive Seidel sign, a narrowed anterior chamber, an intralenticular foreign body, and a traumatic cataract. Ultrasound ruled out retinal and vitreous detachment. Corneal repair, extraction via a scleral tunnel, and aspiration of the lens nucleus were performed; intraocular lens implantation was deferred. Discussion. The corneal location of the wound and the anterior position of the foreign body define a favorable prognostic stratum. Its proximity to the endothelium determined the extraction route and the postponement of aphakic correction. Conclusions: In cases of penetrating ocular trauma, preserving vision depends not only on acting quickly but also on correctly deciding what needs to be addressed first. The presence of a metallic foreign body, a corneal wound, and a traumatic cataract necessitates simultaneous consideration of the integrity of the eyeball. The decision not to immediately implant an intraocular lens in a recently injured eye may represent a prudent reconstructive strategy. In occupational cases, workplace eye protection is identified as the most effective intervention.

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