Keeping an eye on

A 10-year-old boy presents with sudden, severe left eye pain, after that eye was struck by a ricocheting pellet while shooting a BB gun with a friend. He was not wearing protective or prescription glasses at that time.

There are no complaints related to the right eye, and he has no history of ocular trauma, surgery, glasses, or contact lens use. His medical history is unremarkable and he is currently not on any medications.

Select Relevant Investigations
X-ray skull AP & Lateral views

Performed

A single round opacity highly suggestive of a metallic foreign body is seen within the orbit. All other bony structures appear to be normal.
CT bilateral orbits

Performed

The CT reveals a round, metallic foreign body at the level of the iris plane on the left side. All the other orbital structures appear normal.
MRI brain

Performed

You recall that MRI should not be performed on patients who have or are suspected to have metallic foreign bodies.
Electroretinography

Performed

You realize that this is not the right time for an electroretinography.

Select Relevant Management
Tetanus prophylaxis
Fox eye shield
Surgical removal of foreign body
Intravitreal antibiotics