Lead Intraocular Foreign Body Injury Following Ejection

Area of Science:

• Ophthalmology
• Aerospace Medicine
• Toxicology

Background:

• Eye injuries from ejection are rare due to protective gear.
• This case highlights an unusual intraocular lead foreign body from miniature detonator cord (MDC) in a pilot.
• The pilot wore a helmet and visor during ejection from a Hawk aircraft.

Observation:

• A 40-year-old male pilot experienced facial and ocular injuries post-ejection.
• Initial CT scans suggested plastic foreign bodies, but analysis confirmed lead.
• The lead fragments entered the cornea, lens, and vitreous of the left eye.

Findings:

• Spectroscopic and electron microscopy identified lead from the MDC as the intraocular foreign body material.
• Electroretinogram (ERG) revealed reduced scotopic b-wave amplitude in the affected eye.
• Successful pars plana vitrectomy removed the intravitreal foreign bodies, restoring vision from 20/60 to 20/20.

Implications:

• This case demonstrates direct retinal toxicity from intravitreal lead foreign bodies, distinct from systemic lead poisoning.
• It underscores aeromedical concerns regarding MDC splatter risks, even with full protective equipment.
• Successful surgical intervention and ERG monitoring show potential for visual recovery in similar injuries.