• If the FB is anterior, it should carefully be freed and removed. This is relatively easy because access to it is unhindered. The surgeon should know whether the object's distal end has penetrated the eye (open globe injury; the object is appreciated as an IOFB), and if yes, how deep and what additional injuries may have occurred.
• If the FB is posterior, the decision whether and how to remove it becomes more complex.
- If the FB is relatively easily accessible, a scleral cutdown spares patient and ophthalmologists the risks of intraocular surgery, but if major intraocular damage has also occurred, vitreoretinal surgery, alone or in combination with scleral cutdown, may have to be utilized.
- If the object is too posterior to allow convenient ab externo access, the object should either be left in situ4 or removed from the inside.
3 An anteriorly located FB usually penetrates the sclera from the outside (i.e., directly). A posterior FB typically traverses the globe first, and also causes intraocular damage.
4 Vitrectomy may still be indicated to deal with coexisting intraocular pathologies.
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