Closed-globe injury due to metallic foreign body in an elderly worker: A case report

Int J Surg Case Rep. 2023 Sep:110:108694. doi: 10.1016/j.ijscr.2023.108694. Epub 2023 Aug 19.

Abstract

Introduction and importance: Cases of ocular trauma in developing countries are often found with more severe conditions due to increased socioeconomic burden, inadequate safety measures, lack of optimal treatment facilities, and poor education. Here we present a case on an elderly worker in a developing country, showing the importance of prompt treatment albeit in a resource-limited setting.

Case presentation: A 61-year-old male metalworker presented with closed globe injury after metal debris impact during his work shift 3 h ago. Physical examination showed left eye visual acuity of 1/60, conjunctival injection, corneal blood and fibrovascular tissue, a small foreign body, relative afferent papillary defect, and lens opacities. Ultrasound confirmed vitreous cavity abnormalities. Surgical removal of a foreign body and scleral suturing were performed after an 8-hour delay due to limited staff during night shift. Postoperative follow-up indicated improved vision acuity to 3/60. While the overall prognosis was favorable, the patient did not attend subsequent outpatient follow-up appointments, possibly due to financial barriers, raising concerns regarding long-term management.

Clinical discussion: Ocular trauma remains a significant contributor to visual impairment and avoidable blindness, carrying potential long-term implications for quality of life. This case presentation serves as a poignant reminder of the socioeconomic repercussions of ocular injuries, particularly among workers in resource-constrained environments of the developing world.

Conclusion: The notable delays in timely surgical intervention, coupled with financial limitations underline the multifaceted nature of barriers faced.

Keywords: Case report; Closed-globe injury; Elderly worker; Global surgery; Metallic foreign body; Ocular trauma.

Publication types

  • Case Reports