Intraocular Foreign Body

A middle-aged patient sustained a penetrating open-globe injury from an alligator bone fragment while hunting. On presentation, visual acuity was hand motions with a large corneoscleral laceration and disorganized intraocular anatomy. Imaging revealed a hyperdense intraocular foreign body (IOFB) within the posterior segment. The patient underwent urgent globe repair, including closure of a Zone I–II scleral laceration, anterior chamber washout, and pars plana vitrectomy. The posteriorly located IOFB—confirmed intraoperatively to be a fragment of alligator bone—was removed via a large 15mm scleral tunnel. He had an inoperable funnel retinal detachment with extensively shredded retina and subretinal hemorrhage due to the jagged IOFB. The eye was closed and pressurized using silicone oil. Despite timely intervention, the final visual acuity was bare light perception, likely due to initial expulsion of intraocular contents, posterior segment trauma and inoperable retinal detachment. This case highlights the rare occurrence of an organic IOFB of animal origin and the challenges in preventing poor visual outcomes despite aggressive surgical management. It underscores the importance of prompt imaging, broad-spectrum antimicrobial coverage, and the critical need for protective strategies in high-risk environments.

Presentation Date: 04/17/2025

Issue Date: 04/28/2025