BACKGROUND: Ocular siderosis (OS) is a significant cause of visual loss due to retained ferrous intraocular foreign bodies (IOFB). Despite its rarity, OS can lead to severe visual impairment if not promptly diagnosed and treated. This case is notable due to the occult nature of the IOFB, which was undetected by standard imaging modalities, emphasizing the critical role of magnetic resonance imaging (MRI) in such scenarios.
METHODS: A 51-year-old Caucasian male presented with progressive vision loss in his right eye over 20 days. Best corrected visual acuity (BCVA) was 20/1000 in the right eye and 20/20 in the left eye. Intraocular pressure (IOP) was 9 mmHg in both eyes. Slit-lamp examination revealed a small linear corneal wound and an iris defect in the right eye, along with a cataract featuring brownish deposits on the anterior capsule. The left eye was normal. Fundus examination of the right eye was hindered by media opacities. Ultrasonography showed a flat retina and choroid with no detectable IOFB. Despite a strong clinical suspicion of OS, computed tomography (CT) did not detect any IOFB. MRI subsequently identified an artifact in the inferior sectors of the right eye, indicative of a metallic IOFB. Surgical intervention involved a 23-gauge vitrectomy, phacoemulsification, IOFB removal and silicon oil (SO) tamponade resulting in a fully restored VA of 20/20 and normal IOP one month post-operation. SO was removed 2 months later. The retina remained adherent with no PVR development, and optical coherence tomography (OCT) scans showed a normal macula.
CONCLUSIONS: This case underscores the importance of considering OS in patients with unexplained vision loss and history of ocular trauma, even when initial imaging fails to detect an IOFB. MRI proved crucial in identifying the IOFB, highlighting its value in the diagnostic process. Early detection and surgical removal of IOFBs are essential to prevent irreversible visual damage. This case demonstrates that MRI should be employed when CT and ultrasonography are inconclusive, ensuring accurate diagnosis and timely intervention to preserve vision.

This case report describes a diagnosis of iridodialysis in an 11-year-old boy who presented with decreased vision and inflammation after direct blunt trauma to the left eye.

BACKGROUND: This case mainly describes a relatively rare case of an old mineral-like corneal foreign body that existed for up to 20 years, and did not significantly affect the visual quality of the patient.
METHODS: A 56-year-old male miner complained of right eye vision loss for 3 years, swollen and painful for 4 months. Admission examination: Best corrected visual acuity was no light perception in the right eye and 20/20 in the left eye. Anterior segment examination: A large number of spot-like grayish-brown mineral foreign bodies in the conjunctiva of the nasal conjunctiva, emulsified silicone oil floating in the anterior chamber, Corneal foreign bodies in the right eye were widely distributed in the upper cortex and the proelastic layer. There were fewer foreign bodies in the left cornea. Previous medical history, 20 years ago due to forging and burning sulphur mine explosion, resulting in a large number of ore foreign bodies in the conjunctiva of both eyes. As these corneal foreign bodies did not affect the visual quality of the patient, we adopted a conservative treatment plan, did not remove these foreign bodies, and only carried out symptomatic treatment for the patient\'s secondary ocular hypertension. The patient was followed up normally in the outpatient department, and no cornea-related complications occurred up to now.
CONCLUSIONS: First of all, it is necessary to understand the source and nature of the foreign body in patients with corneal and conjunctival foreign body injuries. In the second, for the old corneal metal foreign body, when the patient\'s visual acuity is stable and there are no symptoms of corneal irritation and inflammatory reaction, it can be Conservative treatment or outpatient follow-up observation. In the end, corneal Optical coherence tomography imaging should not be ignored, which is very important for determining the depth of embedding and the location of the corneal foreign body.

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The characteristics of patients with endophthalmitis due to penetrating ocular trauma are still limited. The aim of the study was to fill these gaps among Chinese population. This retrospective study included patients diagnosed as penetrating ocular traumatic endophthalmitis between January 2016 to December 2018. During the past 3-year period, a total of 201 patients with antecedent penetrating eye injuries were evaluated. Of which, 42 (20.9%) patients presented a clinical course compatible with acute infectious endophthalmitis. 39 (92.86%) patients were males, and 15 (35.71%) patients had mechanical injuries from intraocular foreign body (IOFB), the rate of endophthalmitis due to IOFB was 13.43%, higher to the rate among patients without IOFB (7.46%). The duration between injury occurrence and endophthalmitis onset was 1 day in 10 (23,80%) patients; 2 to 7 days in 31 (73.80%) patients, and 7 to 14 days in 1 (2.38%) patient. After 1 year follow-up, best corrected visual acuity (BCVA) better than 20/400 was observed in 15 (35.71%) patients, counting fingers and hand move in 17 (40.48%) patients, light perception in 5 (11.9%) patients and no light perception in 5 (11.9%) patients, respectively. Patients with promising outcomes had better initial BCVA at baseline (P < .001). Endophthalmitis is a severe ocular infectious condition that may lead to irreversible vision loss. A greater attention must be paid to penetrating eye injuries within males, who had poor BCVA at baseline, particularly with obvious IOFB.

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A 54-year-old gentleman presented with a history of poor vision in the right eye for three months and a prior forgotten trauma. The anterior segment was normal. He was diagnosed with subtotal bullous rhegmatogenous retinal detachment (RRD), but no apparent tear was observed. Vitrectomy commenced, and upon exploration, there was a posterior globe rupture with retinal and vitreous incarceration. The scleral wound was sutured with heavy liquid in situ. Orbital imaging post-surgery revealed the presence of an intraorbital foreign body. This is a peculiar presentation of posterior globe rupture, as it was unperceived by the patient, and the slit lamp examination conducted indicated no clinical evidence. Identifying posterior globe rupture remains a challenge that necessitates a high index of suspicion and appropriate management.

During outdoor work in April 2022, a 48-year-old man was stabbed by a tree branch and underwent intraocular foreign body extraction and repair of the scleral wound with sutures and amniotic membrane graft at a local hospital. Steroid therapy with prednisone was prescribed after a diagnosis of uveitis. Vitrectomy was performed in June 2023; a fungal culture was positive, and ITS sequencing identified the organism as Paradictyoarthrinium diffractum. Empiric antifungal therapy did not have an effect, and, because of deterioration of the condition, the left eye was enucleated in October 2023. P. diffractum is a mangrove host-specific saprophytic fungus that has not been reported in humans.

Ocular trauma often involves intraocular foreign bodies (IOFBs) that pose challenges in accurate diagnosis due to their size, shape, and material composition. In this study, we proposed a novel whole-eye 3D ophthalmic ultrasound B-scan (3D-UBS) system for automating image acquisition and improved 3D visualization, thereby improving sensitivity for detecting IOFBs. 3D-UBS utilizes 14 MHz Clarius L20 probe, a motorized translation stage, and a surgical microscope for precise placement and movement. The system\'s 3D point spread function (PSF) is 0.377 × 0.550 × 0.894 mm3 characterized by the full-width at half-maximum intensity values in the axial, lateral and elevation directions. Digital phantom and ex vivo ocular models were prepared using four types of IOFBs (i.e., plastic, wood, metal, and glass). Ex vivo models were imaged with both 3D-UBS and clinical computed tomography (CT). Image preprocessing was performed on 3D-UBS images to remove uneven illumination and speckle noise. Multiplanar reformatting in 3D-UBS provides optimal plane selection after acquisition, reducing the need for a trained ultrasonographer. 3D-UBS outperforms CT in contrast for wood and plastic, with mean contrast improvement of 2.43 and 1.84 times, respectively. 3D-UBS was able to identify wood and plastic IOFBs larger than 250 µm and 300 in diameter, respectively. CT, with its wider PSF, was only able to detect wood and plastic IOFBs larger than 600 and 550 µm, respectively. Although contrast was higher in CT for metal and glass IOFBs, 3D-UBS provided sufficient contrast to identify those. 3D-UBS provides an easy-to-use, non-expert imaging approach for identifying small IOFBs of different materials and related ocular injuries at the point of care.