Unusual presentation of an intraocular foreign body with double – perforation and retention in lateral rectus muscle

Purpose To report a rare complicated case of eye injury with endophthalmitis, an air bubble (bacteria‐produced), retinal detachment, and traumatic cataract, treated surgically with excellent functional outcome. Methods Retrospective analysis of the hard and electronic notes, CT images, OCT images and operation notes. Results 28 year old male presented 5 days post penetrating injury to right eye, with retained metal foreign body. A gas bubble demonstrated on CT in the right superior globe – believed to be bacteria produced. Multi‐stage surgical approach used to treat endophthalmitis, retinal detachment, cataract and removal of FB. Post‐operative outcomes: vision of 6/12 on the affected site, with flat retina, no inflammation and minimal CMO. Conclusions Favourable outcomes are possible with carefully planned and prioritised multi‐stage surgical approach, even in complicated cases with late presentation; described approach may help to optimise outcomes in similar eye trauma presentations.