Abstract

Background: Two case reports concerning a penetrating injury of the eyeball, with a metallic foreign body lodged in the optic nerve disc. Literature data from the past twenty years demonstrated only two such cases.
Material/Methods: Two men, aged 44 and 35 who suffered an eye injury with a metallic chip. The chip lodged itself deep in the optic nerve disc leading towards loss of vision. Electromagnetic traction proved to be unsuccessful. The removal of these foreign bodies by means of vitrectomy proved to be unsuccessful as well. Following 2-4 years these two patients underwent a follow-up examination. We performed an ophtalmological examination, system B and doppler ultrasound.
Results: In case 1, the damaged eye remained blind, while in case 2 the eye possessed light sensation without direction location. Case 1 presented with post-traumatic cataract and infundibular retinal detachment following vitreous body proliferations. Initial siderosis symptoms appeared. Case 2 presented with post-traumatic cataract (removed one month following the accident), without vision improvement. Near the optic disc-macular area we noticed a gliomatous proliferation. The ultrasound examination confirmed the presence of foreign bodies in the optic nerve. We noted no features of ophtalmophthisis.
Conclusions: In spite of absolute indications for the removal of a metallic foreign body from the eyeball (siderosis), treatment in some cases may be ineffective or impossible (deep localization of the foreign body). Siderosis and loss of vision are consequences of such an injury.

Keywords: Optic Nerve, intrabulbar foreign body