Long-lasting Encapsulated Intraocular Foreign Body and Multimodal Imaging Approach

Abstract

Intraocular foreign body represents one of the main causes of severe visual loss. We present the case of a 62-year-old male patient with a history of ocular trauma with metallic intraocular foreign body 42 years ago, who remained asymptomatic and undetected for decades. The diagnosis was incidental, made through computed tomography. Complete ophthalmologic evaluation, including retinography, ocular ultrasonography and optical coherence tomography, identified an echogenic intraocular foreign body encapsulated in the inner retinal surface, located in the inferior temporal retina, without clinical evidence of ocular siderosis. Given the encapsulated nature and the preservation of the retinal structure, conservative management with regular follow-up was chosen. This case highlights the importance of a high index of suspicion and a thorough evaluation in patients with a history of ocular trauma, as well as the role of multimodal imaging in its detection and characterization. In addition, it raises discussion on its optimal management of long-standing encapsulated metallic foreign bodies.