Use of Opportunistic Computed Tomography for Differentiating Intraocular Foreign Bodies

To investigate the opportunistic use of diagnostic focused computed tomography (CT) imaging for differentiating intraocular foreign body (FB) types.

From 2020 to 2024, 49 eyes of 41 consecutive patients with a diagnosis of FB who underwent diagnostic focused CT were prospectively included in this study. CT studies of patients who had direct contact with a known FB and those who had indirect contact with an FB and then underwent surgery were examined. The volume and density (in HU) of the FBs were measured and statistically analyzed.

The type of foreign body was determined by surgery in 34 patients with indirect injuries and by history in 7 patients with direct injuries. Metal was found in 21 eyes, rock in 8 eyes, bullet core in 10 eyes, wood in 2 eyes, glass in 7 eyes, and plastic in 1 eye. Industrial accidents were the cause in 20 patients, traffic accidents in 6 patients, gunshot injuries in 6 patients, and other types of injuries in 9 patients. 21 left eyes, 15 right eyes, and 5 bilateral eyes were affected. Statistical analyses revealed a significant difference in terms of density (HU) between metal and bullet core, rock-bullet core, wood-bullet core, and glass-bullet core (p<0.05).

The majority of intraocular FBs were the result of an industrial accident and were found in the left eye. Bilateral eyes were primarily affected by gunshot injuries. Opportunistic use of CT measurements could accurately differentiate bullet core from metal, glass, stone, wood, or plastic. Left eye protection is particularly important in industrial labor.

· Identification of the material in addition to the site is a significant concern for ophthalmologists.. · CT is the method of choice for the imaging of intraocular foreign bodies.. · Beam hardening artifacts accurately differentiate any metal objects and gunshot bullets from other intraocular foreign bodies with a hyperdense appearance.. · Opportunistic use of routine clinical care CT scans by measuring CT densities aids preoperative differentiation of gunshot bullets from other metal objects..

· Erdem Toslak İ, Erol MK, Karagol Aydinyurt G et al. Use of Opportunistic Computed Tomography for Differentiating Intraocular Foreign Bodies. Rofo 2026; DOI 10.1055/a-2781-9014.