一位於30年前右眼受過創傷之41歲男性，在1996年3月因右眼開放性青光眼接受右眼青光眼小樑切除及周邊虹膜切除術。之前右眼的自動視野檢查顯示出視野縮小，且視神經杯/視神經盤的比例變大。在2002年9月追蹤時發現右眼白內障並於同年10月22日接受白內障摘除手術。然而，術中水晶體移除後即發現一眼內塑膠異物。術前之超音波並未發現此異物，且眼底螢光攝影只顯示出有視網膜色素上皮細胞之變化。這個病例提醒我們：當病患有創傷病史時，即使影像學檢查正常也應懷疑有眼內異物的存在。
A 41-year-old man had suffered trauma to the right eye 30 years ago. In March 1996, he underwent trabeculectomy and peripheral iridectomy under the diagnosis of open angle glaucoma in the right eye. Autoperimetry at that time revealed visual field constriction. In addition, ocular examination showed that the cup/disc ratio of his right eye was increased. Cataract was diagnosed in September 2002 and cataract extraction was performed on October 22, 2002. A plastic intravitreal foreign body was detected during the operation. However, preoperative B-scan ultrasonography had failed to detect an intraocular foreign body (IOFB), and the previous fluorescein angiography had shown only retinal pigment epithelium changes. This case reminded us that we should be alert to an occult IOFB in the event of ocular trauma, even if none had been detected during prior imaging examinations.
關聯:
The Kaohsiung Journal of Medical Sciences 22卷10期 P.529-533
