Neglected Intra-Corneal Foreign Body Since Childhood: A Case Report.

Corneal foreign bodies represent the reason for extremely frequent emergency consultation (65% of ocular traumas), the superficial corneal foreign body constitutes the most frequent traumatic attack of the anterior segment generally occurring during an accident at work, domestic or following an aggression.

The presence of a foreign body on the surface of the eye is the cause of local inflammation responsible for conjunctival hyperemia, edema, or even a cell reaction of the anterior chamber. In case of persistence, the particle can be the cause of an infection, of an adjacent tissue necrosis. However, the evolution can be marked by the epithelial covering of the particle with reduction of the painful phenomena as the case of our patient.

This is a 71-year-old patient who consults for age-related macular degeneration treated several times by intravitreal injections of bevacizumab.

The patient reported the notion of accidental ocular trauma to her left eye during the school period by chalk projection, treated only with aureomycin ointment without ablation. During the consultation, the patient showed no functional signs related to this foreign body.

The ophthalmological examination finds:

Best corrected visual acuity to 8/10 in both eyes.

In the left eye: a superficial subepithelial, paralimbic inferior corneal foreign body with superficial neovascularization, Instillation of fluorescein revealed epithelial covering of the foreign body, with a negative Seidel.

Optical coherence tomography of the anterior segment located a radiopaque subepithelial foreign body with posterior shadow cone.

The foreign body is removed using a sterile needle.

The patient was put under: antiseptic and lubricating eye drops accompanied by a healing ointment with vitamin A and palpebral occlusion.

After complete healing, the patient received treatment for the corneal neovascularization.

The evolution was spectacular.

The presence of a particle at the level of the epithelium, or even more rarely within the corneal stroma generally results from a projection.

Optical coherence tomography of the anterior segment can be useful in order to specify the location of the foreign body in the corneal thickness and to determine the integrity or not of Descemet's membrane,

The clinical picture can be complicated by an inflammatory or even infectious reaction of the cornea, the anterior chamber, endophthalmitis or even corneal neovascularization in persistent forms.

In the absence of treatment, the evolution can also be marked by the epithelial covering of the particle which can be accompanied by a reduction in painful phenomena.

Corneal foreign bodies represent the reason for extremely frequent emergency consultation

The sequelae of corneal CFB are sometimes disabling with a decrease in visual acuity in the event of a central scar or astigmatism induced by this scar.

In case of visual impact of a superficial cicatricial corneal opacity sequelae, a therapeutic excimer laser photokeratectomy can be performed, guided by the corneal topography. The lamellar or full-thickness corneal transplant is reserved only for significant anatomical damage to the cornea.

We insist on the prevention of risks by wearing protective glasses.