Ophthalmic implants and explants

There are a variety of relatively common implants and explants used in ophthalmology. The ED physician should be familiar with and recognize them when they present primarily or secondarily to the ED. The lids and lacrimal system harbor devices that improve physiologic function. The globe is home to the most common implant, the contact lens, and now increasingly, the intraocular lens after cataract surgery. Orbit fractures are often repaired with light metals or other alloplastic materials. The anophthalmic socket, depending on its age, has been filled with many types of implants, some of which may present years later with complications of migration or extrusion. All implants and explants used in ophthalmology can have complications and potentially appear in the ED. Complications that include ocular or orbital infections, especially sight-threatening intraocular infections, require immediate referral. The less-emergent problems mentioned can usually be seen in a few days. The need and timing of ophthalmic referral can be determined with a telephone consultation from the ED.