This patient presented with acute photopsias and a retinal detachment was identified superiorly but incidentally a large metallic intraocular foreign body (IOFB) was noted on dilated exam. There was a history of remote ocular trauma to this eye while grinding metal 3 years prior. There was no evidence of heterochromia but there was mild pigment dusting on the lens that was rust colored and consistent with siderosis. The IOFB is not visible in the fundus photograph, but is seen as a hyperechoic mass opposite the retinal detachment on the B-scan ultrasound.
The IOFB was removed with a rare earth magnet via pars plana approach. The retina was re-attached with perfluoro-n-octane (PFO) liquid, endolaser, air-fluid exchange, and 18% perfluoropropane (C3F8) gas. The only causative break found in the retina was at the site of the IOFB.
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