Undetected intraocular metallic foreign body causing hyphema in a patient undergoing MRI: a rare occurrence demonstrating the limitations of pre-MRI safety screening

The case reported is of a 47-year-old man with an undetected ferromagnetic metallic intraocular foreign body in the right eye who underwent elective MR examinations for chronic neck and low back pain. The patient underwent the MR scans and subsequently developed blurred vision in his right eye caused by a hyphema associated with an anterior chamber metallic foreign body. Case reports of orbital injuries in patients with intraocular metallic foreign bodies undergoing MRI are rare, with only one prior report in the radiology literature. While the incidence of intraocular foreign bodies causing injury in patients undergoing MRI is likely rare even among patients with foreign bodies, this case demonstrates that complications from an IMFB can potentially have a subtle presentation. Our case also illustrates potential limitations of pre-MRI safety questionnaires, particularly pertaining to a patient's understanding of the thoroughness of foreign body removal.