A rare asymtomatic metallic foreign body retained in the subconjunctival space for over 50 years: A Case Report

A rare asymtomatic metallic foreign body retained in the subconjunctival space for over 50 years: A Case Report | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Case Report A rare asymtomatic metallic foreign body retained in the subconjunctival space for over 50 years: A Case Report Wenqi Su, Feng Jiang, Xing Li, Tiangeng He This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3876100/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Superficial foreign body present on the conjunctiva or cornea can be easily detected and removed, and may pose minimal harm if addressed promptly. In this report, we present a case with a metallic foreign body remained within the subconjunctival space for over 50 years without significant ocular complications. Case presentation: An 80-year-old woman complained of tearing and blurred vision in the left eye. Slit-lamp examination showed the presence of a tiny metallic foreign body within subconjunctival space and the cataract in the left eye. No further abnormal findings were observed in the fundus and extraocular components during the examination. After inquiring about the patient's history of trauma, it was revealed that over 50 years ago, the patient experienced an ocular injury from a shard of iron while working at a factory. Since the patient's strong desire to alleviate ocular discomfort, the subconjunctival foreign body was removed under topical anesthesia in the operating room. After a 1-month follow-up, the patient reported the complete relief of tearing symptoms. Conclusions In this case, there appears to be no severe consequences associated with the long-term retention of a subconjunctival metallic foreign body. Nonetheless, it is imperative to conduct meticulous patient evaluations and interventions to mitigate the potential risk of injury. Subconjunctival Metallic Foreign Body long-term retention Figures Figure 1 Figure 2 Background Ocular foreign body injuries are highly common in industrial workplace settings [ 1 ]. Superficial foreign bodies located on the conjunctiva or cornea are usually easily identifiable and removable. When managed effectively, ocular foreign bodies on the ocular surface typically heal without issues [ 2 ]. However, small subconjunctival foreign bodies could be missed initially without thorough assessment, especially when concealed by significant subconjunctival hemorrhage or conjunctival congestion. To the best of our knowledge, the oversight and delayed removal of a foreign body on the ocular surface, especially the metallic fraction, may lead to inflammation, infection, and potential granuloma formation [ 3 ]. Here, we document a rare case of long-term retention of subconjunctival metallic foreign body for 50 years without pronounced clinical consequences. Case presentation An 80-year-old woman attended the clinic with a chief complaint of watering and decreased vision in the left eye for a couple of days. On presentation, she had BCVA of 20/25 in the right eye and 20/20 in the left eye with normal intraocular pressure. The slit-lamp examination revealed the presence of a minuscule metallic foreign body within the subconjunctival space adjacent to the limbus in the nasal region of the left eye, with white and quiet conjunctiva (Fig. 1 ). Upon eyelid eversion, no foreign bodies were identified in the upper and lower tarsal conjunctiva or the fornix. The anterior chamber of both eyes exhibited transparency without the presence of cells or flare, in addition to the observation of cataracts in both eyes. Subsequent examination of the fundus after pupil dilation revealed no anomalies in the posterior and peripheral retina and choroid. The patient's ocular motility is within normal limits. Upon further inquiry into the patient's medical history, she recalled a work-related injury occurred over 50 years ago while engaged in unprotected iron casting work in a factory, leading to ocular trauma from a metallic fragment in her left eye. Fortunately, her visual acuity remained unaffected at that time, and she only received prompt eye irrigation at a local clinic, with no remarkable subsequent manifestations of discomfort. In previous years, the patient also sought medical attention for excessive tearing in her left eye, during which lacrimal irrigation was performed. However, no foreign bodies were detected and removed. Considering the potential risks associated with the metallic foreign body, the foreign body was removed in the operating room. Following topical anesthesia, an incision was made in the conjunctiva near the foreign body for exploration, unveiling the foreign body's position between the conjunctiva and Tenon's capsule. The piece of metallic foreign body fragmented upon attempted extraction with forceps (Fig. 2 ). No scleral defects and siderosis were noted underneath. The patient is prescribed to administer topical antibiotics and corticosteroids daily postoperatively. After a 1-month follow-up, the patient conveyed the total alleviation of tearing symptoms in her left eye. Discussion and conclusions Work-related injuries are the most common type of ocular trauma, with ocular foreign body injuries being one of the most common workplace injuries [ 1 ]. The location of the foreign body in the eye can greatly impact the severity of visual and functional impairments. Timely removal of foreign bodies, reducing the risk of prolonged exposure and subsequent damage to the ocular tissues, offers a better visual prognosis [ 3 ]. The occurrence of superficial conjunctival and corneal foreign bodies are common, but subconjunctival foreign bodies are relatively rare, with a limited number of cases reported to date [ 2 , 4 , 5 , 6 , 7 ]. Here, we present an unusual case of an asymptomatic patient with a metallic foreign body quietly retained in the subconjunctival space for over 50 years. The identification of subconjunctival foreign bodies, particularly those of small size and lacking symptoms of pain or visual impairment, as in this case, can be challenging if no prompt medical attention and comprehensive assessment. The long-term tolerance of the subconjunctival metallic foreign body is more likely the result of natural ocular defense mechanisms, which play a pivotal role in encapsulating and isolating the foreign object within the conjunctival tissue [ 8 ]. This phenomenon may also underlie the current absence of iron deposition. However, various studies have indicated that the formation of a dense fibrous tissue envelope around the foreign body does not consistently impede the spread of metallic ions [ 9 ]. In addition, the extended presence of the metallic foreign body in the subconjunctival space has led to a significant increase in its fragility, suggesting a progressive alteration of its properties. Hence, the long-standing metallic foreign bodies in the ocular region carries inherent risks, encompassing the potential for infection, iron deposition, granuloma formation [ 3 ], and even unforeseeable hazards. Several reports have detailed cases in which patients undergoing MRI examinations for unrelated medical conditions experienced image distortion or discomfort in the eye, revealing that these issues were caused by previously unnoticed ocular metallic foreign bodies that had become magnetized and undergone displacement during the MRI scan, consequently leading to ocular injury [ 9 , 10 , 11 , 12 ]. To this end, the removal of the subconjunctival foreign body through thorough exploration is the optimal strategy to minimize the potential risk of secondary ocular injuries. In this instance, the foreign body was relatively simple to remove, and the patient maintained a BCVA of 20/20 without any adverse effects. In the future, the patient may consider undergoing cataract surgery to address any age-related changes in the eye. Declarations Ethics approval and consent to participate The study was conducted in accordance with the guideline of the Declaration of Helsinki. Consent for publication Written informed consent has been obtained from the patient for the publication of these identifying images and clinical details. Availability of data and materials The Images and video used during the current study available from the corresponding author on reasonable request. Competing interests The authors declare that they have no financial and non-financial competing interests. Funding Not applicable. Authors' contributions Tiangeng He, Feng Jiang, and Wenqi Su contributed to the conception and design of the case report. Data collection was performed by Xing Li. The initial manuscript draft was authored by Wenqi Su. All authors reviewed and approved the final manuscript. Acknowledgments None. References Kyriakaki ED, Symvoulakis EK, Chlouverakis G, Detorakis ET. Causes, occupational risk and socio-economic determinants of eye injuries: a literature review. Med Pharm Rep. 2021;94(2):131-144. Suman S, Kumar A, Rathod HU. Subconjunctival foreign body with suspected scleral penetration. Trauma Case Rep. 2022;38:100613. Pandit K, Khatri A, Sitaula S, et al. Panophthalmitis secondary to retained intraocular foreign body amidst a national lockdown during the COVID-19 pandemic: A case series and review of literature. Ann Med Surg (Lond). 2022;77:103692 Park YM, Jeon HS, Yu HS, Lee JS. A subconjunctival foreign body confused with uveal prolapse. Indian J. Ophthalmol. 2014;62:730‑1. Preston M, Muma KIM. Subconjuctival foreign body mistaken for a scleral tear. Health Press Zambia Bull. 2019;3:49‑51. Jaja Z, Laghmari M, Daoudi R. Scleral granuloma revealing intraocular foreign body. QJM. 2015;108:251‑2. Kaur A. Managing a case of subconjunctival metallic foreign body. Indian J Ophthalmol Case Rep. 2023;3:539-40. Dhoble PY, Velis GB, Sivakaumar P. Encapsulated metallic intraocular foreign body of long duration presenting with cystoid macular edema and normal full-field electroretinogram. Oman J Ophthalmol. 2019;12(1):50-52. Treister G, Keren G. Operative difficulties in removal of retained intraocular foreign bodies by vitreous surgery. Ophthalmologica. 1981;183(3):136-142. Lawrence DA, Lipman AT, Gupta SK, Nacey NC. Undetected intraocular metallic foreign body causing hyphema in a patient undergoing MRI: a rare occurrence demonstrating the limitations of pre-MRI safety screening. Magn Reson Imaging. 2015;33(3):358-361. Ta CN, Bowman RW. Hyphema caused by a metallic intraocular foreign body during magnetic resonance imaging. Am J Ophthalmol. 2000;129(4):533-534. Lagouros PA, Langer BG, Peyman GA, Mafee MF, Spigos DG, Grisolano J. Magnetic resonance imaging and intraocular foreign bodies. Arch Ophthalmol. 1987;105(4):551-553. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-3876100","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Case Report","associatedPublications":[],"authors":[{"id":268033913,"identity":"51c5f7e5-e49e-4cfd-a284-6e53e8b70b6e","order_by":0,"name":"Wenqi Su","email":"","orcid":"","institution":"Tianjin Medical University General Hospital","correspondingAuthor":false,"prefix":"","firstName":"Wenqi","middleName":"","lastName":"Su","suffix":""},{"id":268033914,"identity":"a9bc1b7e-903d-4dc6-86ee-ea8bb91ec3b8","order_by":1,"name":"Feng Jiang","email":"","orcid":"","institution":"Tianjin Medical University General Hospital","correspondingAuthor":false,"prefix":"","firstName":"Feng","middleName":"","lastName":"Jiang","suffix":""},{"id":268033915,"identity":"7046aa0f-0f1c-4ca7-8fa6-bf8f3345bf41","order_by":2,"name":"Xing Li","email":"","orcid":"","institution":"Cangzhou Central Hospital","correspondingAuthor":false,"prefix":"","firstName":"Xing","middleName":"","lastName":"Li","suffix":""},{"id":268033916,"identity":"f1e5fd62-ff3c-4cae-b9ff-63893c3d5fa4","order_by":3,"name":"Tiangeng He","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA3UlEQVRIie3PuwrCMBiG4R8Kuli6SUW0t5DiIIIX09KbcPA0SCbFVfEWHDI6/iGgS6RrwEGhc6HiJCh4Xm1GwTwQyPC9kAAYxg8i94Ovq4WYdbQS65MUQj6TmslbqSHskUbSLE45nle9etNZZmgPwXPK+D1pjQXwidw0WrOUYWUF/nwR5DxMRYA2XYdMbRn6EgKyy0v2CfArXQ+YkgcMqU6iLBA27QYkHgNyrURGRNQo+kwVCB9KV+MvG54cU9r3SCyS06XT9pxqTvImANzn0tWaP/QBHNReG4Zh/JkbaUJTNl0GvGAAAAAASUVORK5CYII=","orcid":"","institution":"Tianjin Medical University General Hospital","correspondingAuthor":true,"prefix":"","firstName":"Tiangeng","middleName":"","lastName":"He","suffix":""}],"badges":[],"createdAt":"2024-01-18 14:44:14","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-3876100/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-3876100/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":49977894,"identity":"e9891529-dd82-4977-ae25-bfaf323f0196","added_by":"auto","created_at":"2024-01-22 14:56:52","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":671466,"visible":true,"origin":"","legend":"\u003cp\u003e(A) A slit-lamp photograph presents a small black metallic foreign body within the subconjunctival space near the limbus in the nasal of left eye. (B) A representative image of the subconjunctival foreign body highlighted with slit lamp.\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-3876100/v1/1d94992a12a2511ba3071496.png"},{"id":49977896,"identity":"516a1610-9b0e-4a8c-bd98-c02313e486f7","added_by":"auto","created_at":"2024-01-22 14:56:52","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":340158,"visible":true,"origin":"","legend":"\u003cp\u003eThe subconjunctival metallic foreign body, extracted intraoperatively with forceps and displayed on a cotton swab, fractured into two pieces.\u003c/p\u003e","description":"","filename":"floatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-3876100/v1/19aeaee14de7dd1d2e36041d.png"},{"id":53829202,"identity":"11ce6ca7-7697-4cb9-a914-6b80ed2955b5","added_by":"auto","created_at":"2024-04-01 04:01:59","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1568838,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3876100/v1/b0dda821-0dc6-4d18-a554-5370ba7b4fc7.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"A rare asymtomatic metallic foreign body retained in the subconjunctival space for over 50 years: A Case Report","fulltext":[{"header":"Background","content":"\u003cp\u003eOcular foreign body injuries are highly common in industrial workplace settings [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Superficial foreign bodies located on the conjunctiva or cornea are usually easily identifiable and removable. When managed effectively, ocular foreign bodies on the ocular surface typically heal without issues [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. However, small subconjunctival foreign bodies could be missed initially without thorough assessment, especially when concealed by significant subconjunctival hemorrhage or conjunctival congestion. To the best of our knowledge, the oversight and delayed removal of a foreign body on the ocular surface, especially the metallic fraction, may lead to inflammation, infection, and potential granuloma formation [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Here, we document a rare case of long-term retention of subconjunctival metallic foreign body for 50 years without pronounced clinical consequences.\u003c/p\u003e"},{"header":"Case presentation","content":"\u003cp\u003eAn 80-year-old woman attended the clinic with a chief complaint of watering and decreased vision in the left eye for a couple of days. On presentation, she had BCVA of 20/25 in the right eye and 20/20 in the left eye with normal intraocular pressure. The slit-lamp examination revealed the presence of a minuscule metallic foreign body within the subconjunctival space adjacent to the limbus in the nasal region of the left eye, with white and quiet conjunctiva (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Upon eyelid eversion, no foreign bodies were identified in the upper and lower tarsal conjunctiva or the fornix. The anterior chamber of both eyes exhibited transparency without the presence of cells or flare, in addition to the observation of cataracts in both eyes. Subsequent examination of the fundus after pupil dilation revealed no anomalies in the posterior and peripheral retina and choroid. The patient's ocular motility is within normal limits. Upon further inquiry into the patient's medical history, she recalled a work-related injury occurred over 50 years ago while engaged in unprotected iron casting work in a factory, leading to ocular trauma from a metallic fragment in her left eye. Fortunately, her visual acuity remained unaffected at that time, and she only received prompt eye irrigation at a local clinic, with no remarkable subsequent manifestations of discomfort. In previous years, the patient also sought medical attention for excessive tearing in her left eye, during which lacrimal irrigation was performed. However, no foreign bodies were detected and removed.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eConsidering the potential risks associated with the metallic foreign body, the foreign body was removed in the operating room. Following topical anesthesia, an incision was made in the conjunctiva near the foreign body for exploration, unveiling the foreign body's position between the conjunctiva and Tenon's capsule. The piece of metallic foreign body fragmented upon attempted extraction with forceps (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). No scleral defects and siderosis were noted underneath. The patient is prescribed to administer topical antibiotics and corticosteroids daily postoperatively. After a 1-month follow-up, the patient conveyed the total alleviation of tearing symptoms in her left eye.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e"},{"header":"Discussion and conclusions","content":"\u003cp\u003eWork-related injuries are the most common type of ocular trauma, with ocular foreign body injuries being one of the most common workplace injuries [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. The location of the foreign body in the eye can greatly impact the severity of visual and functional impairments. Timely removal of foreign bodies, reducing the risk of prolonged exposure and subsequent damage to the ocular tissues, offers a better visual prognosis [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. The occurrence of superficial conjunctival and corneal foreign bodies are common, but subconjunctival foreign bodies are relatively rare, with a limited number of cases reported to date [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Here, we present an unusual case of an asymptomatic patient with a metallic foreign body quietly retained in the subconjunctival space for over 50 years. The identification of subconjunctival foreign bodies, particularly those of small size and lacking symptoms of pain or visual impairment, as in this case, can be challenging if no prompt medical attention and comprehensive assessment. The long-term tolerance of the subconjunctival metallic foreign body is more likely the result of natural ocular defense mechanisms, which play a pivotal role in encapsulating and isolating the foreign object within the conjunctival tissue [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. This phenomenon may also underlie the current absence of iron deposition. However, various studies have indicated that the formation of a dense fibrous tissue envelope around the foreign body does not consistently impede the spread of metallic ions [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. In addition, the extended presence of the metallic foreign body in the subconjunctival space has led to a significant increase in its fragility, suggesting a progressive alteration of its properties. Hence, the long-standing metallic foreign bodies in the ocular region carries inherent risks, encompassing the potential for infection, iron deposition, granuloma formation [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e], and even unforeseeable hazards. Several reports have detailed cases in which patients undergoing MRI examinations for unrelated medical conditions experienced image distortion or discomfort in the eye, revealing that these issues were caused by previously unnoticed ocular metallic foreign bodies that had become magnetized and undergone displacement during the MRI scan, consequently leading to ocular injury [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. To this end, the removal of the subconjunctival foreign body through thorough exploration is the optimal strategy to minimize the potential risk of secondary ocular injuries. In this instance, the foreign body was relatively simple to remove, and the patient maintained a BCVA of 20/20 without any adverse effects. In the future, the patient may consider undergoing cataract surgery to address any age-related changes in the eye.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was conducted in accordance with the guideline of the Declaration of Helsinki.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWritten informed consent has been obtained from the patient for the publication of these identifying images and clinical details.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe Images and video used during the current study available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no financial and non-financial competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTiangeng He, Feng Jiang, and Wenqi Su contributed to the conception and design of the case report. Data collection was performed by Xing Li. The initial manuscript draft was authored by Wenqi Su. All authors reviewed and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNone.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eKyriakaki ED, Symvoulakis EK, Chlouverakis G, Detorakis ET. Causes, occupational risk and socio-economic determinants of eye injuries: a literature review. Med Pharm Rep. 2021;94(2):131-144.\u003c/li\u003e\n\u003cli\u003eSuman S, Kumar A, Rathod HU. Subconjunctival foreign body with suspected scleral penetration. Trauma Case Rep. 2022;38:100613.\u003c/li\u003e\n\u003cli\u003ePandit K, Khatri A, Sitaula S, et al. Panophthalmitis secondary to retained intraocular foreign body amidst a national lockdown during the COVID-19 pandemic: A case series and review of literature. Ann Med Surg (Lond). 2022;77:103692\u003c/li\u003e\n\u003cli\u003ePark YM, Jeon HS, Yu HS, Lee JS. A subconjunctival foreign body confused with uveal prolapse. Indian J. Ophthalmol. 2014;62:730‑1.\u003c/li\u003e\n\u003cli\u003ePreston M, Muma KIM. Subconjuctival foreign body mistaken for a scleral tear. Health Press Zambia Bull. 2019;3:49‑51.\u003c/li\u003e\n\u003cli\u003eJaja Z, Laghmari M, Daoudi R. Scleral granuloma revealing intraocular foreign body. QJM. 2015;108:251‑2.\u003c/li\u003e\n\u003cli\u003eKaur A. Managing a case of subconjunctival metallic foreign body. Indian J Ophthalmol Case Rep. 2023;3:539-40.\u003c/li\u003e\n\u003cli\u003eDhoble PY, Velis GB, Sivakaumar P. Encapsulated metallic intraocular foreign body of long duration presenting with cystoid macular edema and normal full-field electroretinogram. Oman J Ophthalmol. 2019;12(1):50-52.\u003c/li\u003e\n\u003cli\u003eTreister G, Keren G. Operative difficulties in removal of retained intraocular foreign bodies by vitreous surgery. Ophthalmologica. 1981;183(3):136-142.\u003c/li\u003e\n\u003cli\u003eLawrence DA, Lipman AT, Gupta SK, Nacey NC. Undetected intraocular metallic foreign body causing hyphema in a patient undergoing MRI: a rare occurrence demonstrating the limitations of pre-MRI safety screening. Magn Reson Imaging. 2015;33(3):358-361.\u003c/li\u003e\n\u003cli\u003eTa CN, Bowman RW. Hyphema caused by a metallic intraocular foreign body during magnetic resonance imaging. Am J Ophthalmol. 2000;129(4):533-534.\u003c/li\u003e\n\u003cli\u003eLagouros PA, Langer BG, Peyman GA, Mafee MF, Spigos DG, Grisolano J. Magnetic resonance imaging and intraocular foreign bodies. Arch Ophthalmol. 1987;105(4):551-553.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Subconjunctival Metallic Foreign Body, long-term retention","lastPublishedDoi":"10.21203/rs.3.rs-3876100/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3876100/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cb\u003eBackground\u003c/b\u003e\u003c/p\u003e \u003cp\u003eSuperficial foreign body present on the conjunctiva or cornea can be easily detected and removed, and may pose minimal harm if addressed promptly. In this report, we present a case with a metallic foreign body remained within the subconjunctival space for over 50 years without significant ocular complications.\u003c/p\u003e\u003cp\u003e\u003cb\u003eCase presentation:\u003c/b\u003e\u003c/p\u003e \u003cp\u003eAn 80-year-old woman complained of tearing and blurred vision in the left eye. Slit-lamp examination showed the presence of a tiny metallic foreign body within subconjunctival space and the cataract in the left eye. No further abnormal findings were observed in the fundus and extraocular components during the examination. After inquiring about the patient's history of trauma, it was revealed that over 50 years ago, the patient experienced an ocular injury from a shard of iron while working at a factory. Since the patient's strong desire to alleviate ocular discomfort, the subconjunctival foreign body was removed under topical anesthesia in the operating room. After a 1-month follow-up, the patient reported the complete relief of tearing symptoms.\u003c/p\u003e\u003cp\u003e\u003cb\u003eConclusions\u003c/b\u003e\u003c/p\u003e \u003cp\u003eIn this case, there appears to be no severe consequences associated with the long-term retention of a subconjunctival metallic foreign body. Nonetheless, it is imperative to conduct meticulous patient evaluations and interventions to mitigate the potential risk of injury.\u003c/p\u003e","manuscriptTitle":"A rare asymtomatic metallic foreign body retained in the subconjunctival space for over 50 years: A Case Report","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-01-22 14:56:48","doi":"10.21203/rs.3.rs-3876100/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"758cc73c-3c84-44f6-b516-846a88e84fdc","owner":[],"postedDate":"January 22nd, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-04-01T03:53:53+00:00","versionOfRecord":[],"versionCreatedAt":"2024-01-22 14:56:48","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-3876100","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3876100","identity":"rs-3876100","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}