Clinical characteristics, surgical management, and visual outcomes of work-related intraocular foreign body injuries in a tertiary referral center

To describe clinical characteristics, surgical management, and visual outcomes of work-related intraocular foreign body (IOFB) injuries and factors associated with visual acuity (VA) at the last recorded follow-up visit. This retrospective study included 59 patients with work-related IOFBs treated at a tertiary referral center (2017–2025). Clinical and surgical data were recorded, including IOFB location/size, retinal detachment, endophthalmitis, and surgical approach; the Ocular Trauma Score (OTS) was calculated where assessable. VA was converted to logMAR and analyzed continuously. Associations with follow-up VA were assessed with univariable tests and multivariable linear regression (initial VA, retinal detachment, posterior IOFB location, endophthalmitis, and their interaction), plus a follow-up-duration sensitivity analysis. Mean age was 43.5 ± 12.6 years and 98.3% of patients were male. Median VA improved from 0.70 (IQR, 1.85) to 0.30 (IQR, 0.70) logMAR ( p = 0.002). In univariable analyses, worse follow-up VA was associated with worse initial VA, retinal detachment, posterior IOFB location, a higher number of surgeries, traumatic endophthalmitis, proliferative vitreoretinopathy (PVR), and positive relative afferent pupillary defect (RAPD) (all p ≤ 0.020), whereas higher OTS category was associated with better follow-up VA (rs = − 0.608, p < 0.001). In the multivariable model, traumatic endophthalmitis was associated with worse follow-up VA (B = 1.109, 95% CI, 0.557 to 1.661; p < 0.001), with a significant initial VA × endophthalmitis interaction ( p = 0.023). After adjustment for follow-up duration, the endophthalmitis association persisted (B = 0.850, p = 0.004), whereas the interaction was no longer statistically significant ( p = 0.160). Worse initial VA, retinal detachment, posterior IOFB location, a higher number of surgeries, PVR, positive RAPD, and traumatic endophthalmitis were associated with worse follow-up VA, whereas higher OTS category was associated with better visual outcome. Traumatic endophthalmitis remained associated with worse VA after multivariable and follow-up-duration adjustment.