Histochemical Analysis of Anterior Lens Capsule in Chalcosis Bulbi

Abstract

Retained Intraocular Foreign Bodies (RIOFB) can cause significant visual morbidity due to the primary trauma or subsequent secondary complications. Copper Intraocular Foreign Body (IOFB)s can cause ocular changes involving cornea, lens, retina, and vitreous depending on its concentration. This report highlights the histochemical analysis of anterior lens capsule in a case of presumed chalcosis bulbi. A 27-year-old female presented with gradual decrease of vision in Left Eye (LE) since past four months. Best Corrected Visual Acuity (BCVA) in LE was Perception of Light (PL) with inaccurate Projection of Rays (PR). Slit lamp examination showed Kayser-Fleischer ring and sunflower cataract. Posterior segment evaluation revealed diffuse vitreous strands along with vitreous haze. Computerised Tomography (CT) scan orbit was obtained presuming ocular chalcosis which revealed IOFB. Removal of IOFB was not an option due to poor visual prognosis. However, the final diagnosis was cinched by using a copper detecting stain (Orcein) on the anterior lens capsule obtained during cataract surgery. Orcein staining may be used as a surrogate marker for confirmation of copper induced cataract in suspected cases of chalcosis bulbi and is a less expensive alternative to electron microscopy or spectroscopy.

Keywords

• copper deposition
• intraocular foreign body
• orcein stain
• sunflower cataract