Ferenc Kuhn, M.D*, Ph.D, Viktoria Mester, M.D., Robert Morris, M.D., Judit Lang, M.D. United States

Goal:

To help resolve the controversy over the timing for surgery in patients with intraocular foreign bodies – an example of how logic-based thinking can help the ophthalmologist in decision-making.

Method:

A logic-based, critical analysis of the literature.

Results:

Most patients who develop endophthalmitis do so by the time they present to the ophthalmologist – the endophthalmitis rate does not measurably increase afterwards. It is also possible to determine high risk cases in which early intervention is recommended.

Conclusions:

IOFB eyes presenting with endophthalmitis or with a high risk to develop infection must undergo urgent surgery; the intervention may be delayed for a few days in all other patients. Careful review on a logic-based approach of the findings in different published reports allows drawing conclusions that analysis of individual case series cannot provide.

Précis:

In lack of evidence-based medicine, a logic-based approach to management questions in ocular trauma cases can yield better results than relying on anecdotal data or conclusions from small series.