Metallic Corneal Foreign Bodies

Metallic foreign bodies in particular form the largest sub-group, due to small shrapnel from grinding or working with metal. If the mechanism of injury is high velocity, a thorough examination — including possible CT scan — should be performed to rule out any intraocular foreign body. Due to the caustic nature of certain metals, surgical removal may be necessary. Some metal such as titanium may be inert. Others, such as copper, can cause blinding toxic effects.

Fortunately, most metallic foreign bodies remain superficial, causing minimal risk of severe ocular damage. However, over time, metal can oxidize (rust), causing worsened corneal inflammation, redness and light sensitivity. The oxidized material will classically form a rust ring around the area of original foreign body. The metal can (most often) successfully be removed by an emergency room physician or urgent care physician. However, follow-up is often needed with an ophthalmologist to gently polish away any remaining rust. Treatment is important, as ongoing inflammation or surface irregularity can cause susceptibility to sight threatening infections. For this reason, not only should the metal and rust be removed, topical antibiotic should be prescribed for prophylaxis. With adequate and expedient treatment, prognosis for complete and quick recovery is very good.