Ocular golden galaxy: a case of an unusual presentation

Purpose: To report a case of exogenous ocular gold deposition in both eyes associated with sudden onset reduction of vision. Methods: Case report. Results: A 27-year-old, Iranian gentleman presented to emergency department with metallic like foreign body deposition on entire aspect of both eyes associated with intense irritation, tearing and photophobia. On examination, best corrected visual acuity (BCVA) was counting finger in right eye (RE) and perception of light (LP) on left eye (LE). Slit-lamp examination revealed partial thickness corneal laceration in RE extending to sclera and LE disclosed corneal perforation with prolapsed iris, distorted pupil and disrupted anterior lens capsule associated with diffusely golden-brown confluent deposits in both cornea, sclera and conjunctiva. Posterior segment evaluation was impossible on admission day due to severe corneal edema and gold deposition as foreign body accompanied with very severe irritation.RE penetrating keratoplasty performed for patient due to diffuse corneal opacity. LE lensectomy and anterior vitrectomy was done in two separate sections. After 1 year of follow up, patient was asymptomatic and BCVA improved to 5/10 in RE but it was LP in LE secondary to macular scar formation secondary to severe tractional macular edema. Ocular media is clear and fundus is healthy in RE. Conclusion: although gold is safe and inert, it can lead to sacrifice of eyesight and life-threatening complications when contaminated with other toxic elements. Immediate and prolonged irrigation followed by proper management is essential for patients who present after acute injury and early recognition of such injuries.