Persistent Lower Lid Swelling in an Infant – Impacted Foreign Body!
conjunctiva is avoided leading to prolonged tolerance
and minimal irritation8. However, in our case, we did
not find any evidence of granuloma formation, except
for mild hyperemia.
Mohammad Owais Arshad; Senior Registrar: Critical
analysis, Acquisition of Data, final review.
Mohammad Hanif Chatni; Head of Department:
Concept, final review.
There are cases in literature in which unusual
subconjunctival foreign bodies are reported. Park et al
have described a foreign body which was confused
with uveal prolapse9. Similarly, subconjunctival insect
wings are also reported10.
REFERENCES
1. Balakrishnan E, Abraham JE, Naim-ud-Din M.
Unusual foreign body in the conjunctiva. Br J
Ophthalmol. 1963; 47: 250–2.
With this author communication, the authors wish
to highlight the importance of a thorough yet proactive
history and clinical examination, which are often
neglected due to poor co-operation in children, and
lack of awareness among parents too. In our case the
foreign body had been there for one month. It was
missed at three levels, i.e. by the parents, by the
ophthalmologist and by the pediatrician. A missing
part of a toy, elucidated on history, should always raise
the suspicion among parents and/or care givers for a
probable foreign body in children. The concept of a
“holistic” approach towards the patient tops the list
when providing medical care.
2. Sakata, C., Hiraoka, T., & Oshika, T. Unusually
Large Plastic Toy as a Persisting Conjunctival Foreign
Body. Japan J Ophthalmol. 2007; 51 (3): 232234.
Doi: 10.1007/s10384-007-0434-5.
3. Gerding H. Unusually long foreign body of the
conjunctival fornix in a child overlooked by 3
ophthalmologists.
Klinische
Monatsblätterfür
Augenheilkunde. 2013; 230 (04): 390-1.
Doi: 10.1055/s-0032-1328391.
4. Qayum S, Anjum R, Rather S. Epidemiological
profile of pediatric ocular trauma in a tertiary hospital
of northern India. Chinese journal of traumatology.
2018; 1; 21 (2): 100-3.
5. Giuliano EA. Diseases of the adnexa and nasolacrimal
system. Equine Ophthalmology. 2016; 27: 197.
6. Weinberg JC, Eagle Jr RC, Font RL, Streeten BW,
Hidayat A, Morris DA. Conjunctival Synthetic Fiver
Granuloma: A Lesion that Resembles Conjunctivitis
Nodosa. Ophthalmology. 1984; 91 (7): 867-72.
7. Sowmya V, Nazareth NE, Kamath VB. Foreign-body
conjunctival granuloma secondary to finger-nail
trauma. Asian J Ophthalmol. 2015; 14; 14 (2): 73-6.
8. Alabi EB, Simpson TL. Conjunctival Redness
Response to Corneal Stimulation. Optometry and
Vision Science. 2019 Jul 1; 96 (7): 507-12.
Ethical Approval
The study was approved by the Institutional review
board/Ethical review board.
Conflict of Interest
Authors declared no conflict of interest.
Authors’ Designation and Contribution
Doi: 10.1097/OPX.0000000000001398.
Javeria Nasir; Registrar: Concept, data collection,
manuscript writing.
9. Park YM, Jeon HS, Yu HS, Lee JS.
A
subconjunctival foreign body confused with uveal
prolapse. Indian J Ophthalmol. 2014 Jun; 62 (6): 730–
731.
Anum Javed; Resident: Manuscript writing, final
review.
10. Fogla R, Rao SK, Anand AR, Madhavan HN. Insect
wing case: Unusual foreign body. Cornea. 2001; 20:
119–21.
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