A case of prolonged corneal sulfur foreign bodies and review of literature

TL;DR

A 56-year-old miner had corneal foreign bodies for 20 years without significant vision loss, leading to a conservative treatment approach.

Contribution

Highlights the long-term stability of corneal foreign bodies without vision impact and advocates conservative management when asymptomatic.

Findings

Corneal foreign bodies remained stable for 20 years without affecting visual quality.

Conservative treatment was effective for asymptomatic, deeply embedded foreign bodies.

Optical coherence tomography is crucial for assessing foreign body depth and location.

Abstract

This case mainly describes a relatively rare case of an old mineral-like corneal foreign body that existed for up to 20 years, and did not significantly affect the visual quality of the patient.

A 56-year-old male miner complained of right eye vision loss for 3 years, swollen and painful for 4 months. Admission examination: Best corrected visual acuity was no light perception in the right eye and 20/20 in the left eye. Anterior segment examination: A large number of spot-like grayish-brown mineral foreign bodies in the conjunctiva of the nasal conjunctiva, emulsified silicone oil floating in the anterior chamber, Corneal foreign bodies in the right eye were widely distributed in the upper cortex and the proelastic layer. There were fewer foreign bodies in the left cornea. Previous medical history, 20 years ago due to forging and burning sulphur mine explosion, resulting in a large number of ore foreign bodies in the conjunctiva of both eyes. As these corneal foreign bodies did not affect the visual quality of the patient, we adopted a conservative treatment plan, did not remove these foreign bodies, and only carried out symptomatic treatment for the patient’s secondary ocular hypertension. The patient was followed up normally in the outpatient department, and no cornea-related complications occurred up to now.

First of all, it is necessary to understand the source and nature of the foreign body in patients with corneal and conjunctival foreign body injuries. In the second, for the old corneal metal foreign body, when the patient’s visual acuity is stable and there are no symptoms of corneal irritation and inflammatory reaction, it can be Conservative treatment or outpatient follow-up observation. In the end, corneal Optical coherence tomography imaging should not be ignored, which is very important for determining the depth of embedding and the location of the corneal foreign body.

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