A case of delayed-onset endophthalmitis due to intraocular iron foreign body detected by MRI

Purpose : To report a case of intraocular iron foreign body found by magnetic resonance imaging (MRI). MRI is prohibited in a patient who has metal in the body, and the reports of its images are rare. Case : A 40-year-old man felt pain of the left eye hitting a concrete wall with a chisel. The next day, he underwent a medical examination at the ophthalmology clinic. However, the left eye has no abnormal findings. After 2 months, he noted photophobia on the left eye and presented with mydriasis. The neurologist found intraocular iron foreign body on the left eye by MRI and CT and referred the patient to our clinic. Findings and clinical course : Left visual acuity was 0.8. The anterior chamber and lens were clear. The iris had a part of atrophy. A slightly vitreous opacity and intraocular iron foreign body were found near the ora serrata on the upper side. We selected an observasion because the subjective symptom and the objective symptom were mild. Endophthalmitis occured two and a half months after the accident. Phacoemulsification with aspiration ( without injection of intraocular lens) and vitrectomy were performed on the left eye. Cutibacterium acnes was detected in the culture from the vitreous body. Endophthalmitis was treated by eye drops and intravenous drip of antibiotics. Injection of intraocular lens was performed after 6 months of the accident. Finally, visual acuity recovered to 1.2. Conclusions : MRI should not be perform in a patient who cannot be denied with intraocular iron foreign body. However, we unexpectedlly obtained the characteristic MRI images.