A patient sustains a penetrating injury with a retained intraocular metallic foreign body. Months later he develops golden-brown Kayser-Fleischer-like ring, anterior subcapsular cataract with distinctive 'sunflower' appearance, and heterochromia iridis (affected eye is darker). The pathological ion responsible is:
- A Copper (chalcosis) ✓
- B Iron (siderosis bulbi)
- C Lead (plumbism)
- D Calcium (calcific band keratopathy)
Correct answer: A. Copper (chalcosis)
Explanation
Chalcosis results from intraocular copper foreign body (>85% copper content causes acute chalcosis; lower copper alloys cause delayed chalcosis). Copper deposits in the ocular tissues via oxidative mechanisms producing: greenish-gold KF-ring in Descemet's membrane, sunflower cataract (anterior subcapsular brown-gold deposits), heterochromia (copper in iris stroma causing darker colour), and retinal copper deposits. Siderosis from iron causes rust-brown heterochromia, rust-coloured anterior capsule pigment, and retinal degeneration. Lead and calcium cause different patterns.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
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Written and medically reviewed by the StethoPrep medical team.