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    Occult Intraocular Foreign Bodies After Nail Gun Injury

    AAO 2022 Video Program
    Diagnostic & Imaging , Retina/Vitreous, Vitreoretinal Surgery

    A 20-year-old man presented to the emergency room after a nail from a nail gun ricocheted into his left eye. The patient removed the nail from his eye and noted pain and worsening vision. His vision was hand motion with a 4+ afferent pupillary defect. He had a full-thickness corneal laceration, hyphema, and traumatic cataract. Orbital computed tomography (CT) showed a collapsed left globe with vitreous hemorrhage and no radiopaque foreign bodies. The patient underwent immediate globe repair. He developed a white cataract with no view to the fundus, with a very dense vitreous hemorrhage on B-scan. Two weeks after globe repair, he was taken for pars plana vitrectomy and lensectomy. After the cataract was removed and very dense vitreous hemorrhage was cleared, 4 intraocular foreign bodies (IOFBs) were noted that had not been detected on CT or B-scan. These long, thin radiolucent foreign bodies were likely eyelashes.

    Financial Disclosures: Drs. Nhon Le and Tahira Scholle disclose no financial relationships.