Ocular siderosis secondary to occult intraocular foreign body causing secondary glaucoma: A case report.

Background: Occult intraocular foreign bodies (IOFBs) can present with atypical symptoms and clinical signs, making diagnosis challenging. We describe a case of an undetected IOFB that was missed on both computed tomography and B-ultrasound, ultimately leading to ocular siderosis and secondary glaucoma.

Case Summary: A 55-year-old male patient presented to our clinic reporting a one-month history of right ocular discomfort and progressive visual deterioration. The patient had previously received a glaucoma diagnosis at a local healthcare facility. His ocular history included blunt trauma to the affected eye five years prior to presentation. Slit-lamp examination revealed corneal and iris lesions in the right eye. Pupillary dilation facilitated the identification of traumatic lens opacities. Diagnostic imaging modalities, including B-scan ultrasonography and computed tomography, showed no evidence of retained intraocular foreign material. The patient subsequently underwent uncomplicated pars plana vitrectomy, during which the occult foreign body was successfully extracted. The procedure was completed without intraoperative or immediate postoperative complications.

Conclusion: Awareness of IOFBs in individuals who work in high-risk occupations and prompt referral to a retinal surgeon are very important.