This document discusses penetrating ocular injuries and intraocular foreign bodies. Key points include: 1) Evaluate for other injuries, apply a shield, and do not use drops with an open globe injury. Examine under anesthesia if an open globe is suspected. 2) Corneal wounds may be linear or lacerated and may involve the iris. Suturing and cryotherapy may be needed depending on location and size. 3) Traumatic cataracts and injuries to the posterior capsule or iris can result from lens wounds. 4) Intraocular foreign bodies can cause mechanical effects, introduce infection, and elicit specific tissue reactions depending on the material. Diagnosis involves examination for the wound and imaging. Treatment

1. Penetrating Injuries&
Intra ocular Foreign bodies

2. Things to do in a case of Open Globe injury
• 1)Evaluate the other system injury
• 2)Apply shield over the involved eye
• 3)Do not apply Drops / ointments
• 4) Examine under Anaesthesia

3. Suspect open globe injury
• 1)When the Globe is Distorted
• 2) When the intra ocular contents are seen
• 3) When the AC is shallow
• 4) History of injury with Sharp objects

4. Corneal wounds
• May be Linear or Lacerated
• May be associated with Iris Prolapse
• If Iris tissue is Non- viable, it has to be Excised
• Wounds are sutured with 10 “0” Nylon
• Scleral wounds more than 3 mm posterior to
the Limbus are to be sutured and Cryo
application to be done

5. Corneal laceration

6. Wounds of the LENS
• Cause Traumatic Cataract
• may result in Posterior Capsule injury
• May result in Irido cyclitis

7. Traumatic cataract( Rosette)

8. Intra ocular Foreign Body
• The effects are due to;
• 1) Mechanical Effects
• 2) Introduction of infection
• 3) Specific action of metal on the Tissues

9. Mechanical Effects
• Depending on the velocity, the Foreign body
can lodge in the Angle, Iris or Pentrate the lens
• It may be retained in the vitrous and cause
Degn
• If it lodges in the Retina,it gets encapsulated
by Fibrous Tissue
• In the Posterior sgt, they cause Degnerative
changes.

10. Infection
• This is a ever present danger in Penetrating
• injuries
• Common with sand, wood.
• Metallic foreign bodies are usually sterilised
by the velocity

11. Reaction of ocular tissues
• A) Inert: Glass, Plastics, Porcelein
• Gold, silver, Platinum& Titanium
• B) Local tissue reaction- Aluminium
• C) Severe Reaction- siderosis bulbi- Iron
• Chalcosis - copper

12. Diagnosis
• Careful search for wound of entry
• Diligent slit lamp examination
• Radiography For Radio-opaque foreign bodies
• Computerized axial tomography
• MRI is contraindicated
• Ultra sonography

13. Treatment
• Fb in the Lens- lens removal
• FB in the Vitreous removal after vitrectomy
• FB On The Retina Removal after vitrectomy
• If it is an Inert Fb it is better left alone