Intraocular foreign bodies: a systematic review and meta-analysis of clinical manifestations, diagnostic challenges and management strategies
In brief
Two thirds of eyes attain 20/40 vision after intraocular foreign-body removal
In a review of 4,289 patients, 65.7% achieved best-corrected visual acuity of 20/40 or better, CT identified foreign bodies in over 90% of cases and pars plana vitrectomy succeeded in 96.5% of surgeries. Removing the object within 24 hours was linked to better visual recovery and fewer complications, underscoring the need for rapid diagnosis and treatment.
- Journal
- The British journal of ophthalmology (Q1)
- Published
- 4 August 2026
- Study design
- Systematic review of cohort studies
- Evidence level
- Level 2, Moderate (CEBM 2a)
- Authors
- Priyanshi Priya, Nibha Mishra, Niraj Kumar Yadav, Priyanka Sharma, Apjit Kaur Chhabra
- PMID
- 42552100
- DOI
- 10.1136/bjo-2026-329418
Why clinicians should know about it
- Picked for Ophthalmology (top studies of the week, 9 August 2026): SR of cohorts, IOFB management improves visual outcomes
Abstract
BACKGROUND/AIMS: Retained intraocular foreign bodies (IOFBs) are important causes of vision-threatening ocular trauma and preventable visual impairment. This systematic review and meta-analysis evaluated the clinical manifestations, diagnostic approaches, surgical management and visual outcomes associated with IOFBs. METHODS: A systematic search of PubMed, Embase, Scopus and Web of Science identified studies published between 1 January 2000 and 30 November 2025. Eligible studies reporting clinical presentation, imaging findings, management strategies or outcomes of retained IOFBs were included. Data were synthesised using a random-effects meta-analysis model. RESULTS: A total of 59 studies involving 4289 patients were included of which 42 were eligible for quantitative meta-analysis. Reduced visual acuity (78%), ocular pain (42%) and intraocular inflammation (36%) were the most common clinical manifestations. Endophthalmitis occurred in 12.4% and retinal detachment in 9.8% of cases. Favourable visual outcomes (Best Corrected Visual Acuity-BCVA≥20/40) were achieved in 65.7% of patients. CT demonstrated the highest diagnostic accuracy (91.2%), while ultrasonography showed 83.6% sensitivity particularly in media opacity. Pars plana vitrectomy was the predominant surgical approach, with an overall surgical success rate of 96.5%. Early IOFB removal (≤24 hours) was associated with improved visual recovery and reduced complications. CONCLUSIONS: Early diagnosis and timely surgical intervention are critical for optimising outcomes in retained IOFBs. CT and pars plana vitrectomy remain central to management, while delayed intervention increases the risk of severe complications. Standardised protocols and prospective multicentre studies are needed to strengthen evidence and improve patient care.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.