A rare asymptomatic metallic intraocular foreign body retained in the anterior chamber for 15 years A case report

Rationale: Intraocular foreign bodies (IOFBs) are common in ocular injuries, but asymptomatic metallic IOFBs retained in the anterior chamber for years are rare. Patient concerns: A 31-year-old female presented with blurred vision in her right eye after lumbar magnetic resonance imaging. Her best-corrected vision acuity was 0.6 in the right eye and 1.0 in the left eye. Slit-lamp examination revealed a brown granular foreign body in the anterior chamber and pigmentation of the limbus. Lens and retina examination indicated ocular siderosis. Corneal endothelioscopy revealed decreased endothelial cell density. A detailed history showed ocular globe injury 15 years earlier. Diagnoses: Anterior chamber IOFB with ocular siderosis. Interventions: Anterior chamber foreign body removal was performed with appropriate incision and forceps. Outcomes: The anterior chamber IOFB was successfully removed and examined as a magnetic metal foreign body. The best-corrected vision acuity was 1.0 at 1 day postoperatively. An abnormal electroretinogram with a 12% decrease in the "b" wave and a 91% decrease in the "a" wave was observed 3 months postoperatively. There were no intraoperative or postoperative complications during a 3-month follow-up. Lessons: Eye trauma should be examined carefully to exclude IOFBs. Asymptomatic anterior chamber foreign bodies can also cause corneal endothelial injury and ocular siderosis. Careful examination and timely management are needed in such cases.