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| OPHTHALMIC IMAGE |
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| Year : 2020 | Volume
: 58
| Issue : 4 | Page : 325-326 |
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Mercedes benz sign-intraocular triradiate thorn injury during COVID-19 pandemic
Bharat Gurnani1, Kirandeep Kaur2
1 Department of Cataract, Cornea and Refractive Services, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Pondicherry, India
2 Department of Pediatric Ophthalmology and Squint Services, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Pondicherry, India
| Date of Submission | 05-Aug-2020 |
| Date of Acceptance | 21-Sep-2020 |
| Date of Web Publication | 16-Dec-2020 |
Correspondence Address:
Dr Kirandeep Kaur
Department of Pediatric Ophthalmology and Squint, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Pondicherry - 605 007
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/tjosr.tjosr_105_20
How to cite this article:
Gurnani B, Kaur K. Mercedes benz sign-intraocular triradiate thorn injury during COVID-19 pandemic. TNOA J Ophthalmic Sci Res 2020;58:325-6 |
A 35-year-old young male presented to our outpatient clinic with complains of pain, redness and burning sensation in the right eye (RE) since 2 days. He gave a history of foreign body fall in the RE while travelling on the bike 2 days ago. Snellen's best-corrected visual acuity was 6/6 in both eyes. Intraocular pressure was 16 mmHg and 14 mmHg in RE and left eye (LE) respectively. Slit lamp biomicroscopic examination in RE revealed diffuse conjunctival congestion [Figure 1]a and [Figure 1]b with Few abrasion over the cornea and rest of the anterior segment was normal. Correlating with the abrasion, single eversion of the upper lid revealed a triradiate thorn buried with base in, in the upper tarsal conjunctiva (UTC) [Figure 2] and [Figure 3]. The thorn was removed from the UTC with needle under topical anesthesia under aseptic precautions. The morphological appearance of the thorn mimics the classical Mercedes Benz sign. Triradiate thorn as an ocular foreign body is a common occurrence in South India. Although common in this region but very scarce reports are available in the literature. This is probably the first report of intraocular triradiate thorn depicting the Mercedes Benz sign. | Figure 1: (a) Image of the right eye of the patient depicting temporal bulbar conjunctival congestion. (b) Image of the right eye of the patient depicting nasal bulbar conjunctival congestion
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 | Figure 2: Image of the triradiate thorn (white arrow) removed from the upper tarsal conjunctiva of right eye of the patient
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 | Figure 3: Image depicting the schematic diagram of triradiate thorn and its analogy with Mercedes Benz sign
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Ocular thorn injuries can be a serious concern and can result in varied complications.[1] It can manifest as penetrating injury to the eye or can result in conjunctivitis, corneal ulcer, corneal abscess, anterior chamber perforation, iris trauma, vitritis or even endophthalmitis.[2],[3] Early diagnosis, prompt removal of foreign body and meticulous management are a must to salvage the eye and prevent vision threatening sequelae.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given his consent for his 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.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | |  |
| 1. | Mader TH, Werner RP, Chamberlain DG. Corneal perforation and delayed anterior chamber collapse from a devil's club thorn. Cornea 2008;27:961-2.  |
| 2. | Elghazi T, Eljai A, Elkaddoumi M, Lazrek O, Saoudi SH, Belkbir T, et al. Conjunctival granuloma following neglected thorn injury: about a case. Pan Afr Med J 2016;25:8. |
| 3. | Regragui A, El Atiqi A, Sabrane I, Handor H, Hafidi Z, Berradi S, et al. Long standing well-tolerated intracorneal thorns. J Fr Ophtalmol 2016;39:e283-4. |
[Figure 1], [Figure 2], [Figure 3]
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