Bullous Keratopathy Secondary to Anterior Chamber Angle Foreign Body

Penetrating ocular trauma with intraocular foreign body is a serious injury often resulting in loss of vision. Anterior chamber foreign bodies account for a considerable portion of all cases of all intraocular foreign bodies (up to 15%); however, they can be missed due to inconspicuous location.

We report two cases of retained intraocular foreign bodies in the iridocorneal angle that was missed at the first ophthalmic examination. They were only discovered when complications occurred, such as corneal edema and increased intraocular pressure. In the case whereby the foreign body was taken out early, corneal damages were reversible. However, in the case whereby the foreign body was taken out late, endothelial damage was irreversible and endothelial transplantation was needed.

Regarding trauma patients, a careful examination should be performed to discover foreign bodies in the iridocorneal angle. If local peripheral corneal edema occurred, attention should be paid to the trauma history and to timely discovery of the foreign body. This will prevent any irreversible corneal damages.