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
cornea
partial or complete Kayser-Fleischer ring (blue-green)
iris
greenish hue to affected eye, causing heterochromia between the 2 eyes
lens
sunflower/rosette cataract
vitreous fluid
opacification
retina
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
To read more or access our algorithms and calculators, please log in or register.
