Intraocular ferritin production due to an iron-containing intraocular foreign body

Ocular siderosis is a rare but severe complication of open globe trauma with intraocular retention of a metallic foreign body. We report a case of recurrent uveitis in a 37-year-old patient. The ophthalmic examination revealed poor vision in the left eye, lid edema, limbal scleromalacia, hyphema and severe ocular hypertension. Orbital CT showed the presence of a radio-opaque IOFB between the crystalline lens and vitreous body. An aqueous humor sample was obtained for iron and ferritin levels. The results came back 100 and 2000 times higher, respectively, than the serum reference values. The very high iron content is the result of a sustained release from the metallic INFB and is responsible for ocular siderosis in our patient. The extremely high ferritin level would be the result of in situ synthesis by the various cells of the ocular structures in order to preserve the components of the eye. Measurement of these two levels would improve the diagnosis, prognosis and treatment of metallic IOFBs.