Unusual case of intraocular foreign body.

A patient who recently came under my care had been struck in the right eye by a foreign body whilst hammering a piece of steel with hammer and cold chisel. A diagnosis of intra-ocular foreign body was made, there being a small entrance wound in the centre of the cornea and an opaque lens. This diagnosis was confirmed by x ray. The foreign body, measuring about 3j x 1 x 1 mm. was located in the posterior segment of the globe Operation was performed on the same day (that following the injury) and an attempt was made to remove the foreign body by the posterior route. This attempt was unsuccessful, much to my surprise, as the foreign body was a large one and should have come out easily. I had originally been told both by the patient, and by his employer that the foreign body had come from the metal which he was working and not from his chisel or hammer, but I was inclined to view this with some scepticism as it is generally found that the foreign body is provided by the workman's tool rather than by the metal being worked. After this failure to remove the foreign body I decided to investigate the matter further. Unfortunately the eye became infected and had to be removed about a week later. The foreign body was retrieved from the posterior segment where it was lying almost up against the disk, with one end in fairly close proximity to the operation wound. The foreign body was sent to the laboratory at the factory where the patient worked, and was found to be a piece of austenitic steel of the type on which he was working at the time of the accident. It did not come from the hammer or chisel. Austenitic steels, of which stainless steel is an example, are non-magnetic in the normal state, but acquire slight magnetic properties on being cold workedchipping with a chisel is an example of such cold working. These steels are used in industry for their heat-, scaling-, and rust-resisting properties. Fig. 1 shows the fragment of austenitic steel actually removed from this patient's eye; Fig. 2 shows fragments obtained by chipping with hammer and chisel.