Retained subretinal date palm tree thorn in a child

Area of Science:

• Ophthalmology
• Microbiology

Background:

• Ocular trauma from vegetative matter poses a significant risk of microbial keratitis and endophthalmitis.
• Date palm tree injuries can introduce unique pathogens and foreign bodies into the eye.

Observation:

• A 3-year-old boy presented with a corneal laceration and traumatic cataract after a date palm collision.
• Bacillus cereus was isolated from a thorn, and a subretinal foreign body was identified.
• The patient received broad-spectrum antibiotics prophylactically due to high endophthalmitis risk.

Findings:

• Despite the retained subretinal foreign body, there were no clinical signs of endophthalmitis or retinal detachment.
• Cataract extraction and laser demarcation of the foreign body were performed.
• Visual acuity improved to 20/30 with an aphakic contact lens and patching.

Implications:

• This case highlights the importance of considering and managing ocular trauma from plant material, including potential deep-seated foreign bodies.
• Aggressive prophylactic antibiotic treatment is crucial in high-risk eye injuries.
• Successful visual rehabilitation is possible even with retained intraocular foreign bodies under specific circumstances.