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Photo Essay | October 2004

Symblepharon as the Only External Sign of an Occult Intraocular ForeignBody

Simon D. M. Chen, FRCOphth; C. K. Patel, FRCOphth

Arch Ophthalmol. 2004;122(10):1562. doi:10.1001/archopht.122.10.1562.

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A 54-year-old man had an isolated right inferotemporal symblepharonprior to cataract surgery (Figure 1).The patient reported that his face had been exposed to an exhaust blast froman aircraft engine 5 weeks previously. There was no other history of trauma.

Results from an anterior segment examination were otherwise unremarkable.Fundoscopy revealed a lesion in the temporal retina (Figure 2). B-scan ultrasonography suggested that this was an intraocularforeign body (Figure 3). An electroretinogramshowed reduced rod and cone amplitudes compatible with siderosis bulbi, thusnecessitating extraction of the intraocular foreign body. A metallic intraocularforeign body (Figure 4) was successfullyremoved with pars plana vitrectomy and an intraocular magnet.

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Figure 1.

A symblepharon in the inferotemporalfornix.

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Figure 2.

Fundus photograph demonstratinga lesion in the temporal retina.

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Figure 3.

B-scan ultrasonograph showinga highly reflective retinal lesion with acoustic shadowing suggestive of anintraocular foreign body.

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Figure 4.

Metallic intraocular foreign bodyretrieved using an intraocular magnet at the time of vitrectomy surgery.

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Chen SM, Patel CK. Symblepharon as the Only External Sign of an Occult Intraocular ForeignBody. Arch Ophthalmol. 2004;122(10):1562. doi:10.1001/archopht.122.10.1562.

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