Siderosis bulbi following a retained intraocular iron foreign body is characterized by which specific clinical triad?

• A Rust-colored deposits in anterior capsule and pupillary zone, iris heterochromia, electrophysiological changes (reduced ERG), progressive retinal degeneration ✓
• B Brownish iris discoloration, dilated fixed pupil, cataract with brown anterior capsule deposits
• C White cataract, phthisis bulbi, and calcification on X-ray
• D Chalcosis (golden ring on Descemet's membrane), sunflower cataract, and hepatic cirrhosis

Explanation

Siderosis bulbi from retained iron foreign body: iron deposits disseminate throughout ocular tissues, causing rust-colored deposits in lens anterior capsule (siderotic cataract), iris becoming lighter (heterochromia siderans), and most importantly, progressive retinoxidative toxicity causing reduced and abnormal ERG (especially scotopic b-wave) leading to retinal degeneration and vision loss. ERG monitoring is the most sensitive tool to detect early siderosis and decide timing of IOFB removal. Chalcosis (copper deposits) causes sunflower cataract and Kayser-Fleischer-like ring — this is from copper IOFB, not iron.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

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Written and medically reviewed by the StethoPrep medical team.