Stony Intraocular Foreign Body (Eye of Stone)

Background

Ocular traumata are relevant sight threatening incidents [1]. Males are more often involved than females as well as rural dwellers more often than urban inhabitants [2]. Most accidents occur at work (60 %) followed by accidents at home (24 %) [2].

Risk factors for a poor visual outcome are rupture of the globe, scleral wound extending further than 5 mm posterior to the limbus, scleral wound of equal or more than 10 mm, ciliary body damage, severe intraocular hemorrhages and choroidal damage (i. e. choroidal laceration, choroidal detachment, choroidal rupture, choroidal incarceration, and choroidal defect), closed funnel retinal detachment or extraocular retinal prolapse [3].

A consistent terminology and a precise trauma classification are indispensible to ensure optimal trauma management. Commonly used are the Birmingham-Eye-Trauma-Terminology (BETT, [Fig. 1]) [4] [5] and the Ocular-Trauma-Score (OTS) [5] [6] [7] [8].

Fig. 1 Ocular trauma classification adapted from F. Kuhn, Ophthalmology 1996; 103: 240 – 243.

• References

• 1 Rofail M, Lee GA, O'Rourke P. Prognostic indicators for open globe injury. Clin Experiment Ophthalmol 2006; 34: 783-786
• 2 McCarty CA, Fu CL, Taylor HR. Epidemiology of ocular trauma in Australia. Ophthalmology 1999; 106: 1847-1852
• 3 Feng K, Hu YT, Ma Z. Prognostic Indicators for No Light Perception After Open-Globe Injury: Eye Injury Vitrectomy Study. Am J Ophthalmol 2011; 152: 654-662
• 4 Kuhn F, Morris R, Witherspoon CD. Birmingham Eye Trauma Terminology (BETT): terminology and classification of mechanical eye injuries. Ophthalmol Clin North Am 2002; 15: 139-143, v
• 5 Kuhn F, Morris R, Witherspoon CD et al. A standardized classification of ocular trauma. Ophthalmology 1996; 103: 240-243
• 6 Kuhn F, Morris R, Witherspoon CD et al. A standardized classification of ocular trauma. Graefes Arch Clin Exp Ophthalmol 1996; 234: 399-403
• 7 Pieramici DJ, Sternberg Jr P, Aaberg Sr TM et al. A system for classifying mechanical injuries of the eye (globe). The Ocular Trauma Classification Group. Am J Ophthalmol 1997; 123: 820-831
• 8 Kuhn F, Maisiak R, Mann L et al. The Ocular Trauma Score (OTS). Ophthalmol Clin North Am 2002; 15: 163-165, vi
• 9 Kuhn F. Strategic thinking in eye trauma management. Ophthalmol Clin North Am 2002; 15: 171-177
• 10 Strahlman E, Elman M, Daub E et al. Causes of pediatric eye injuries. A population-based study. Arch Ophthalmol 1990; 108: 603-606
• 11 Feng K, Shen L, Pang X et al. Case-control study of risk factors for no light perception after open-globe injury. Eye Injury Vitrectomy Study. Retina 2011; 31: 1988-1996