Cilia can enter into the eye either as a result of penetrating surgery[3,6] or penetrating injury.[1–3,5,7,9] Post-traumatic intra-ocular cilia events comprise a small portion (0.4%) of all intra-ocular foreign bodies. Cilia can be entrapped in the cornea, AC, posterior chamber, lens, vitreous, or retina or can migrate into the eye.[3,4,6,7,9–12] Anterior chamber cilia account for 45% of all intra-ocular ciliae.
The response of the eye to the intra-ocular cilia is unpredictable and variable. In the early post-traumatic or post-surgical course, both infection and inflammation can cause a severe ocular reaction. Intra-ocular cilia can be associated with corneal edema, corneal graft rejection, granulomatous and non-granulomatous iridocyclitis, cyst formation, lens abscess vitreous traction, retinal detachment and endophthalmitis.[1,4,7,8] Although cilia may remain inert for many years, exacerbation with delayed inflammatory reactions of various severity may occur, ending with blindness.
A literature review revealed that cilia entrapped in the AC can sometimes cause inflammation[3,8] and can sometimes remain innocuous.[2,9,11,12] In the literature, there is a report of silent cilia existing in the AC for 33 years. To the best of our knowledge, our report is the first case of post-traumatic cilia that has remained silent for approximately 50 years. The asymptomatic course of intra-ocular cilia is related to its relatively inert nature compared to other organic materials and the immune privileged feature of the eye. Based on this fact, some practitioners prefer observation in asymptomatic cases,[2,9] while others prefer surgical intervention to eliminate the potential of devastating endophthalmitis.[6–8]
J Med Case Reports. 2011;5(527) © 2011 BioMed Central, Ltd.