Siderosis from a retained intraocular stone.

A penetrating intraocular stone caused a retinal detachment that was repaired successfully. The patient returned 18 months later with siderosis bulbi. The patient was followed by serial neurosensory tests for the next three years. The electro-oculogram (EOG) showed the greatest abnormality, while the electroretinogram (ERG) and dark adaptation, although initially affected, showed no further deterioration. Surgical procedures on this eye included linear extraction of the siderotic lens, anterior vitrectomy, and irrigation of a hyphema. Fluorescein angiogram revealed a siderotic deposit on the retina. Progressive visual field loss prompted removal of the stone foreign body by an eye-wall resection technique. Five years later vision was 20/30. While dark adaptation, EOG, and ERG remained stable, the visual fields showed progressive constriction. Fluorescein angiogram revealed pigment epithelial defects, cystoid macular edema, reduced peripheral circulation, and progressive clearing of the retinal iron deposits.