About the Journal | Editorial Board | Instructions to Contributors | Submission & Review | Advertise with Us | Subscribe to E- Alerts
Sitemap | Feedback | Follow Us 
Advanced search
The Official Scientific Journal of Delhi Ophthalmological Society
Transparent Corneal Foreign Body - A Diagnostic Challenge in Children
Jitender Jinagal, Gaurav Gupta, Deepak Chandra Maurya, Jagat Ram
Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
Corresponding Author:
Jagat Ram 
MS
Professor of Ophthalmology
Advanced Eye Center,
Director, Post Graduate Institute of Medical Education and Research (PGIMER)
Sector 12, Chandigarh - 160012, India
Email id: drjagatram@gmail.com
Published Online: 01-NOV-2018
DOI: http://dx.doi.org/10.7869/djo.397
Abstract
A 5-years-old male, presented with unilateral itching, watering and photophobia, treated as allergic conjunctivitis elsewhere, with no improvement. On slit-lamp biomicroscopy, a shining reflex in superficial stroma was noted and anterior segment optical coherence tomography (AS-OCT) was suggestive of some foreign body (FB). On examination under anaesthesia, thin transparent plastic paper sheet FB was found and removed. Postoperatively, the FB impaction site was healed and replaced by a nebular corneal opacity. To conclude, careful examination as well as AS-OCT is helpful in detection of retained transparent intra-corneal foreign bodies especially in paediatric age group, in which history is not always reliable.
A 5 year old male presented with chief complaints of itching, watering and intolerance to light in the left eye since three months. They consulted two general ophthalmologists locally who treated him as allergic conjunctivitis and he was advised olopatadine and carboxymethylcellulose eye drops, but showed no improvement. The child was not cooperative for visual acuity and intraocular pressure evaluation. On slit-lamp biomicroscopy, his right eye examination was within normal limits; a shining reflex in the superficial stroma in the supero-medial quadrant of the left cornea was noted (Figure 1). The epithelium over that reflex was irregular and pooling of dye was present on fluorescence staining. On history, no history of trauma or something falling into the eye was revealed. Anterior segment optical coherence tomography (AS-OCT) revealed a hyper-reflective reflex in the superficial stroma completely covered by epithelial layers (Figure 2), and the presence of back-shadowing beneath the area of hyper-reflectivity which was suggestive of a foreign body (FB). A possible diagnosis of retained intra-corneal transparent FB (probably glass or plastic sheet) was made and the child was advised examination under anaesthesia for diagnostic and therapeutic purposes. After drying the cornea with Merocyl sponge intra-operatively, the FB, which was found to be a thin plastic paper sheet under the operating microscope (Figure 3), was removed with forceps and sent for microbiological examination. The unhealthy overlying epithelium was scraped and bandage contact lens was applied. Postoperatively, two hourly gatifloxacin 0.5% and carboxymethylcellulose 1% eye drops were advised. Microbiological culture did not show any growth. The FB impaction site healed and was replaced by nebular corneal opacity at two weeks postoperatively (Figure 4). Postoperative AS-OCT showed an area of corneal scarring and thinning in the same area (Figure 5). To conclude, careful biomicroscopic examination as well as AS-OCT is helpful in detection of retained transparent intra-corneal foreign bodies especially in the paediatric age group, in which history is not always reliable.






Article Options
FULL TEXT
ABSTRACT
PDF
PRINTER FRIENDLY VERSION
Search PubMed for
Search Google Scholar for
Article Statistics
CITE THIS ARTICLE
Jitender Jinagal, Gaurav Gupta, Deepak Chandra Maurya, Jagat RamTransparent Corneal Foreign Body - A Diagnostic Challenge in Children.DJO 2018;29:49-50
CITE THIS URL
Jitender Jinagal, Gaurav Gupta, Deepak Chandra Maurya, Jagat RamTransparent Corneal Foreign Body - A Diagnostic Challenge in Children.DJO [serial online] 2018[cited 2018 Dec 13];29:49-50. Available from: http://www.djo.org.in/articles/29/2/Transparent-Corneal-Foreign-Body.html
Bookmark and Share