A 43-year-old male presented with photophobia, watering, and gradual, painless diminution of vision in the left eye (OS) for the past 2 months. These symptoms followed a gunshot injury sustained at the time of onset. On examination, the best corrected visual acuity (BCVA) in OS was 6/12; N18. Slit-lamp bio microscopy revealed multiple foreign bodies embedded in the cornea Fig. 1a and subconjunctival space Fig. 1b. To further evaluate the location and depth of these foreign bodies, anterior segment optical coherence tomography (AS-OCT) was performed. It revealed a sharply defined hyperreflective anterior surface, complete posterior shadowing due to lack of signal penetration, and absence of internal structural detail, consistent with a dense metallic object Fig. 1c. This case underscores the importance AS-OCT in real-time surgical planning by precisely delineating the depth and location of the foreign body. The decision of approach via anterior, posterior, or combined route can be made prudently based on AS-OCT imaging.1Figure 1: (a) – Slit-lamp photography of the left eye under diffuse illumination demonstrates multiple foreign bodies embedded within the corneal stroma. A central diffuse nebular scar is seen, accompanied with numerous nummular corneal opacities. (b) – Slit-lamp photo of the left eye demonstrating multiple foreign bodies in subconjunctival space. (c) - AS-OCT of the left eye, showing hyperreflective foreign body with posterior back shadowing (red arrow) and intact Descemet’s membraneAuthors contributions Mona Bhargava - concept, design, definition of intellectual content, and manuscript review. Yash Kadhane - manuscript preparation, data acquisition, data analysis, Neha Chaudhary - manuscript preparation, literature search, manuscript editing. Poulami Roy- manuscript preparation, manuscript editing and manuscript review. Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed. Financial support and sponsorship: Nil. Conflicts of interest: There are no conflicts of interest.
Bhargava et al. (Thu,) studied this question.