Retained large nail with perforating injury of the eye

To report a case of a mixed open globe injury in which a retained large iron nail and perforating injury of the eye coexisted.

Case report.

A 26-year-old construction worker was injured by a nail while using a nail gun at work. The iron nail was inadvertently stabbed into the left eye from the upper eyelid and superonasal sclera to temporal sclera, with lens involvement. His visual acuity was counting fingers in the left eye. Primary suture, removal of a retained iron nail, pars plana vitrectomy and lensectomy, and laser photocoagulation were performed. Three months later, an intraocular lens was implanted in the ciliary sulcus. During postoperative 6-month follow-up, final best-corrected visual acuity was 20/20 without complication.

We describe one patient with a mixed open globe injury of a retained nail and perforating injury of the eye resulting from a nail gun. As most eye injuries are preventable, proper training of nail-gun operators and use of safety equipment could reduce the incidence of ocular injuries. Expeditious removal of nails and repair of the lacerations can prevent the complications and achieve good final visual outcomes.