Occult intraocular aluminum foreign body causing Rhegmatogenous retinal detachment:A case report

Abstract

AbstractBackground:Ocular trauma is complex and varied, and some occult intraocular foreign bodies(IOFB) can lead to uncommon symptoms and signs. We report a case of rhegmatogenous retinal detachment (no obvious wound, no pain,no intraocular infection and other symptoms) caused by an occulted intraocular aluminum foreign body, which could easily been missed without careful preoperative examination.It has not been reported to our knowledge.Case presentation:A 42-year-old male presented to the outpatient department of our hospital complaining black dots fluttered and decreased vision of his left eye initiated 3 months earlier.He was diagnosed as "floaters " at a community hospital. He denied history of ocular trauma or previous surgery.The cornea and lens of the left eye were clear.A small patch of pigmentation was noted in the temporal sclera. Fundoscopy revealed macula off retinal detachment.After mydriasis, elliptical holes were seen in the peripheral retina at 2:30,suspicious strip of hyperreflectance was found under the retina of the anterior lip under Goldmann three mirror contact lens examination, which was confirmed to be IOFB by orbital CT.The IOFB was removed through the pars plana vitrectomy without any complications.Conclusion:Unlike iron and copper, aluminum intraocular foreign bodies are more inert and more likely to be missed.For people with special occupations (such as construction workers, mechanic, etc.), when abnormal pigmentation of the sclera is found, the possibility of foreign bodies in the eye should be vigilant.It is necessary, in the process of disease diagnosis and treatment,to ask detailed history including occupation history and practice, careful physical examination and targeted examination.Such comprehensive analysis of the above information will minimize the chance of missed diagnosis.