Case 21: Zone I Open Globe Injury with Anterior Foreign Body from a Pencil Tip

  • Benjamin JastrzembskiEmail author
  • Natalie Wolkow
  • Seanna Grob
  • Ankoor S. Shah


An 11-year-old boy presented with a Zone I open-globe injury of the right eye with a piece of pencil graphite embedded in the wound. The patient underwent repair of the open-globe injury with removal of the pencil graphite piece, scraping of the corneal wound edges, and tight wound apposition with 10-0 nylon sutures to promote optimal healing of the round corneal wound. Four weeks following the injury, the corneal sutures were removed in the operating room due to the patient’s age. The patient had a final visual acuity of 20/20 in the injured eye.


Zone 1 open-globe injury Pencil Anterior foreign body Pediatrics 

Supplementary material

432788_1_En_26_MOESM1_ESM.mp4 (149.9 mb)
Video 26.1 Case 21_Zone I penetrating open globe injury (MP4 153531 kb)


  1. 1.
    United Nations Scientific Committee on the Effects of Atomic Radiation. Sources and effects of ionizing radiation. New York: United Nations; 2010.Google Scholar
  2. 2.
    Patel SN, Langer PD, Zarbin MA, Bhagat N. Diagnostic value of clinical examination and radiographic imaging in identification of intraocular foreign bodies in open globe injury. Eur J Ophthalmol. 2012;22(2):259–68.CrossRefPubMedGoogle Scholar
  3. 3.
    Han ER, Wee WR, Lee JH, Hyon JY. A case of retained graphite anterior chamber foreign body masquerading as stromal keratitis. Korean J Ophthalmol. 2011;25(2):128–31.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Jeng BH, Whitcher JP, Margolis TP. Intracorneal graphite particles. Cornea. 2004;23(3):319–20.CrossRefPubMedGoogle Scholar
  5. 5.
    Guy JR, Rao NA. Graphite foreign body of the conjunctiva simulating melanoma. Cornea. 1985-1986;4(4):263–5.CrossRefPubMedGoogle Scholar
  6. 6.
    Hamanaka N, Ikeda T, Inokuchi N, Shirai S, Uchihori YA. Case of an intraocular foreign body due to graphite pencil lead complicated by endophthalmitis. Ophthalmic Surg Lasers. 1999;30(3):229–31.PubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Benjamin Jastrzembski
    • 1
    Email author
  • Natalie Wolkow
    • 1
  • Seanna Grob
    • 1
  • Ankoor S. Shah
    • 2
  1. 1.Department of OphthalmologyHarvard Medical School, Massachusetts Eye and EarBostonUSA
  2. 2.Department of OphthalmologyHarvard Medical School, Boston Children’s Hospital and Massachusetts Eye and EarBostonUSA

Personalised recommendations