Missed Intraocular Foreign Body Presenting As Siderosis Bulbi: Two Case Reports

Ocular siderosis bulbi is a rare but significant cause of vision impairment in patients with a retained ferrous intraocular foreign body (IOFB). In this report, we present two cases of ocular manifestations suggestive of siderosis bulbi. Both cases presented with a significant reduction in vision and were found to have a dense cataract, a small healed corneal scar, and siderotic pigments in the anterior chamber. The first case denied any past ocular injury, yet CT scans confirmed the presence of an IOFB. The second case, who had a high suspicion of ocular trauma, did not have a radiologically detectable IOFB. Both cases underwent combined cataract extraction surgery with pars plana vitrectomy and IOFB removal, resulting in a favorable visual outcome despite developing siderosis.