The patient was 60 years old. 46 years ago, he was injured in his right eye by a flying stone while playing with his partner. He was admitted to the hospital on December 14, 2004 with traumatic cataract. Examination: visual acuity of the right eye: manual/30cm, accurate light localization, normal red-green vision. There was a 3mm long strip scar at 7:00 position of the right cornea 3mm from the corneal limbus, and a 2mm×2mm hole in the corresponding iris. The anterior chamber was normal in depth and the atrial fluid was clear. The pupil was round and centered, with a diameter of 3mm and a sensitive reflex to light. The crystal is porcelain white and uniformly cloudy, with iris pigmentation on the surface after pupil dilatation. The fundus is not visible. The intraocular pressure was normal. The left eye and general examination were normal. On December 16, 2004, cataract extraction and posterior chamber IOL implantation were performed under local anesthesia, and the operation went smoothly.
Discussion The damage to intraocular tissues caused by intraocular foreign bodies is related to the nature and size of the foreign body. Magnetic foreign bodies cause more serious chemical damage to ocular tissues, which will not only lead to complete clouding of the lens sooner or later, but even cause extensive ocular ironosis. Smaller non-magnetic foreign bodies cause less damage to intraocular tissues and can often remain in the crystal for a long time without causing progressive crystal clouding, and are generally considered to have good vision and a clear crystal, which can be conservatively observed. With large foreign bodies, crystal clouding is evident, while with small foreign bodies, crystal clouding is more limited, and this relative quiescence can persist for months to years. In this case, the foreign body in the crystal was small, and after entering the crystal, the anterior capsule of the crystal had a small rupture, and the crystal remained intact through the repair of the epithelial cells of the crystal or by covering the adhesion of the iris tissue to close the wound, and only limited clouding occurred; moreover, the foreign body was a non-magnetic substance, and no chemical reaction occurred, and the patient did not have any obvious discomfort after the injury and did not consult the doctor in time, resulting in the foreign body remaining in the crystal for 46 years until the crystal was completely clouded The foreign body was only discovered at the time of surgery. Therefore, for cases with obvious history of trauma, detailed medical history should be taken, careful and repeated examination should be done, and ocular X-ray, B-ultrasound or CT examination should be done if necessary, in order to prevent the diagnosis from being missed, and for those who seek treatment after cataract formation, attention should be paid to the removal of the foreign body during surgery.