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Year : 2020  |  Volume : 58  |  Issue : 3  |  Page : 215

Impacted stone in the anterior chamber: A rare observation

1 Department of Ophthalmology, Sri Sankaradeva Nethralaya, Guwahati, Assam, India
2 Department of Glaucoma, Sri Sankaradeva Nethralaya, Guwahati, Assam, India

Date of Submission22-May-2020
Date of Acceptance22-Jun-2020
Date of Web Publication14-Sep-2020

Correspondence Address:
Dr. Suklengmung Buragohain
Departments of Ophthalmology, Sri Sankaradeva Nethralaya, Guwahati, Assam
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/tjosr.tjosr_60_20

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How to cite this article:
Kumari N, Buragohain S, Javeri HJ, Tayab S. Impacted stone in the anterior chamber: A rare observation. TNOA J Ophthalmic Sci Res 2020;58:215

How to cite this URL:
Kumari N, Buragohain S, Javeri HJ, Tayab S. Impacted stone in the anterior chamber: A rare observation. TNOA J Ophthalmic Sci Res [serial online] 2020 [cited 2020 Oct 25];58:215. Available from: https://www.tnoajosr.com/text.asp?2020/58/3/215/295000

  Introduction Top

Cases of ocular trauma with intraocular foreign bodies (IOFBs) in the anterior chamber are relatively rare (15% of IOFBs). They are most commonly associated with nonmetallic projectiles with lower velocity.[1] A majority of such incidences can be prevented with protective eyewear.

  Etiopathogenesis Top

During any kind of penetrating trauma, the direction and site of impact, along with the mass and velocity of the foreign body (FB), determines its final position inside the eye. Objects with lower mass (usually nonmetallic) and lesser velocity seem to remain in the anterior chamber after penetration of the cornea.[1] Such cases occur when there is splashing of the FB, commonly seen during drilling and without protective eyewear.[2] In contrast, objects with a greater mass such as metallic FBs come to lie more commonly in the posterior segment.[1]

  Case Report Top

A 54-year-old male quarry worker presented with diminished vision and pain in the right eye (OD) after a piece of stone hit the eye, when he was drilling a few hours back. On examination, visual acuity in OD was counting fingers close to the face, improving to 6/9 with pinhole. Slit-lamp biomicroscopy of OD revealed diffuse conjunctival congestion, a self-sealed (Seidel's negative) corneal wound with localized corneal edema and a 4 mm × 5 mm (approximately) piece of stone lodged in the pupil, lying between the lens and the iris [Figure 1]. The lens capsule and iris appeared to be normal without any damage. Posterior segment was within normal limits. The patient was advised for OD primary corneal repair with FB extraction, but unfortunately, he failed to follow-up for the surgery.
Figure 1: Slit-lamp photograph. (a) Under diffuse illumination, the corneal entry wound and behind it the stone can be seen lodged in the pupil between the lens and the iris and (b) slit-section showing the longitudinal dimension of the stone

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Such FBs should be managed as early as possible due to the potential of giving rise to serious complications such as endophthalmitis, hyphema, cataract, and retinal detachment.[3],[4] Prompt management is of importance, but wearing protective eyewear is the first step in avoiding such injuries.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

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Conflicts of interest

There are no conflicts of interest.

  References Top

Archer DB, Davies MS, and Kanski JJ. Non-metallic foreign bodies in the anterior chamber. Brit J Ophthal 1969;53:453.  Back to cited text no. 1
Li L, Lu H, Ma K, Li YY, Wang HY, Liu NP. Etiologic causes and epidemiological characteristics of patients with intraocular foreign bodies: Retrospective analysis of 1340 cases over ten years. J Ophthalmol 2018;2018:6309638.  Back to cited text no. 2
Yeh S, Colyer MH, Weichel ED. Current trends in the management of intraocular foreign bodies. Curr Opin Ophthal 2008;19:225-33.  Back to cited text no. 3
Williams DF, Mieler WF, Abrams GW. Intraocular foreign bodies in young people. Retina 1990;10 Suppl 1:S45-9.  Back to cited text no. 4


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