An intraocular foreign body composed of copper can result in different reactions depending on its location and copper composition. The copper ions tend to be deposited in basement membranes, causing less toxicity than iron deposits.


A key factor determining the host reaction and outcome is the percent copper in the foreign body. Foreign bodies with a high percentage of copper are rare.

Percent Copper

Clinical Syndrome

<= 85%

chalcosis (from the Greek chalkos)

> 85%

acute fulminant, sterile endophthalmitis


The deposits are not attracted to a magnet unless an alloy of copper and iron.


Anatomic Site

Clinical Finding in Chalcosis


partial or complete Kayser-Fleischer ring (blue-green)


greenish hue to affected eye, causing heterochromia between the 2 eyes


sunflower/rosette cataract

vitreous fluid



refractile precipitates in the macular region with sparing of the periphery


Prognosis is affected by:

(1) whether the foreign body is removed

(2) occurrence of endophthalmitis (with high purity copper)

(3) vitreous opacities

(4) cataract

(5) macular toxicity


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