Intraocular foreign body: Characteristics, visual outcomes, and predictive values of ocular trauma score

Nawat Watanachai; Janejit Choovuthayakorn; Onnisa Nanegrungsunk; Phichayut Phinyo; Susama Chokesuwattanaskul; Krittai Tanasombatkul; Linda Hansapinyo; Phit Upaphong; Tuangprot Porapaktham; Apisara Sangkaew; Atitaya Apivatthakakul; Paradee Kunavisarut; Voraporn Chaikitmongkol; Direk Patikulsila

doi:10.1016/j.heliyon.2023.e20640

Intraocular foreign body: Characteristics, visual outcomes, and predictive values of ocular trauma score

Heliyon. 2023 Oct 4;9(10):e20640. doi: 10.1016/j.heliyon.2023.e20640. eCollection 2023 Oct.

Authors

Nawat Watanachai¹, Janejit Choovuthayakorn¹, Onnisa Nanegrungsunk¹, Phichayut Phinyo^{2

3

4}, Susama Chokesuwattanaskul⁵, Krittai Tanasombatkul^{2

3}, Linda Hansapinyo¹, Phit Upaphong¹, Tuangprot Porapaktham¹, Apisara Sangkaew¹, Atitaya Apivatthakakul¹, Paradee Kunavisarut¹, Voraporn Chaikitmongkol¹, Direk Patikulsila¹

Affiliations

¹ Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Thailand.
² Clinical Epidemiology and Clinical Statistics Center, Faculty of Medicine, Chiang Mai University, Thailand.
³ Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Thailand.
⁴ Musculoskeletal Science and Translational Research (MSTR), Chiang Mai University, Chiang Mai, Thailand.
⁵ Center of Excellence for Cornea and Stem Cell Transplantation, Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.

Abstract

Introduction: Retained intraocular foreign body (IOFB) remains an important cause of acquired visual impairment. The visual prognosis following treatments for eyes with retained IOFB was observed to be distinct from other mechanisms of open globe injury due to the specific nature and associated circumstances. This study evaluated the risk behaviors, visual results, and predictive values of Ocular Trauma Score (OTS) in determining visual outcomes in patients with IOFB that were not related to terrorism.

Methods: Medical records of patients who underwent surgical interventions between January 2015 and December 2020 were retrospectively reviewed.

Results: A total of one hundred and sixty-one patients (162 eyes) were recruited. The patients had a mean (standard deviation) age of 47.6 (14.0) years with working male predominance (93.2%). The majority of patients were injured by activities related to grass trimming (63.4%) and metallic objects were the main materials causing injuries (75.7%). Following treatments, the proportion of eyes having vision worse than 20/400 decreased from 126 eyes (77.8%) to 55 eyes (33.9%) at final visit. Ocular trauma score (OTS) had a high potential prediction for final vision in eyes in OTS categories 4 and 5. However, the discordance of final visual acuity distribution was observed in some subgroups of eyes in OTS categories 1 to 3.

Conclusion: This study highlights the significance of IOFB related eye injuries in a tertiary care setting. Decision making on treatments should be carefully considered, particularly in eyes in lower OTS categories, in light of a rise in the proportion of patients who experience improved vision after IOFB removal.

Keywords: Characteristics; Intraocular foreign body; Ocular trauma score; Visual outcomes.