Complications Due to a Foreign Body in the Eye

If for one or another reason the metallic fragments have not been removed from the eye, there may be severe complications connect­ed with gradual oxidation of the metal and penetration of oxides into eye tissue (metallosis). Metallosis is manifested in different terms after getting of the fragment into the eye — from several weeks to some months and sometimes years. Besides characteris­tic clinical signs, it is very important to perform electrophysiologi­cal investigation of the eye for early diagnosis.

Siderosis. Fragments containing iron while oxidating cause rus­ting of the eye — siderosis. It is gradual dissolution of the foreign body and saturation of the eye tissue with inorganic and organic compounds of iron. The first signs of siderosis may be detected in several months after trauma. It is, first all, change of the iris co­lour which turns rusty. The spots of rusty colour appear in the epi­thelium of the anterior lenticular capsule.

Pupil response to light becomes inert. Iron salt deposit in the ret­ina causes hemeralopia, toxic retinopathy and then neuroretino-pathy. On objective examination the picture of the eye fundus re sembles changes in pigmental retinal regeneration. At later stages large white atrophic foci can be seen in the central sections of the eye fundus, the disc of the optic nerve becomes rusty. These phe­nomena may result in complete blindness, recurrent iridocyclitis or absolute secondary glaucoma.

Chalcosis. Copper fragments also cause changes in the eye. Chalcosis develops slowly due to copper oxide deposit in the eye tissues. Initial changes in the anterior part of the eye develop quick­ly in chalcosis, during first months after trauma — 65% of patients. Copper salt deposit in the lens cause copper cataract: formation of green-yellowish opacities resembling a sun-flower in blossom. If there is copper fragment in the vitreous, the latter grows turbid with white threads and films in the greenish or orange mass. There is always an inflammatory process around the copper fragment in the eye, a zone of aseptic suppuration is formed. The tissue in this zone is quickly dissolved forming abscess and creating conditions for fragment transfer. Chalcosis may cause iridocyclitis, second­ary glaucoma, retinal dystrophy. Not infrequently copper foreign bodies lead to eye atrophy.

Metallosis treatment. The most effective method of metallosis treatment is early surgical removal of the foreign body. When it is impossible to remove the fragment, we administer treatment di­rected at decrease of metallosis signs. To treat siderosis we re­commend 5% solution of unitiol (antidote of heavy metals) as in­stillations, both subconjuctival (0.2 ml) or intramuscular injections by the scheme, retinol as well as inductive currents of high frequen­cy. To treat chalcosis we recommend 5% solution of sodium tio-sulfate as instillations, intravenous infusions, baths and ointments, ionization with reverse mark both separately and with preliminary diathermia. There are data on beneficial results in chalcosis treat­ment with retinol and unitiol. Dissolving therapy is considered use­ful to decrease siderosis and chalcosis.

Date: 2015-02-03; view: 1057