Metal Corneal Foreign Bodies

A corneal metal foreign body (CMFB) and its associated rust ring are important to remove in a timely fashion to minimize the instance of corneal scarring and/or permanent decrease in vision. Commonly CMFB occurs in men between 19 and 41 years of age, working in industrial, construction, and automotive settings are at highest risk of presenting as an emergency visit to the office (Arora R, et al. Indian J Ophthalmol. 2000;48(2):119–22). There has been a prior correlation between poor educational background, low socioeconomic standing, and the dearth of education in the individuals most commonly presenting with CMFB. Standard of care in treating CMFB includes a thorough case history, evaluation of visual acuity and pupillary response, anesthetizing the patient, selecting the appropriate instrument(s) for removal of the CMFB and rust ring, performing dilated fundus exam using cyclopentolate, inserting a BCL, and prescribing an antibiotic-steroid combination drop follow-up in 24 h for BCL removal. Severe complications of retained CMFB can include traumatic iritis, siderosis bulbi, and chalcosis. The use of prophylactic antibiotic/steroid combination reduces scarring by strengthening the extracellular matrix of the corneal stroma. It is essential to fully remove the rust ring and rule out a possible intraocular foreign body to ensure the best visual outcome. This case report explores corneal metal foreign body (CMFB) and its management.