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Suggested management strategy for removing electrochemically active galvanized steel intraocular foreign bodies

no signs of zonular dehiscence. We presume that the triamcinolone crystals may have therefore passed between the zonules after either refluxing through the site of needle passage or ruptured the anterior vitreous face. Alternatively there may have been a subclinical zonular dehiscence. Pseudohypopyon following IVTA injection occurs because of migration of triamcinolone acetonide crystals into the AC and was first reported by Chen et al. The incidence ranges from 0.2% to 1.9% and is more likely to occur in aphakic and pseudophakic eyes or in previously vitrectomized eyes. It is rare in phakic eyes with no history of prior interventions. The symptoms can range from mild discomfort to sudden decrease in vision. The onset of hypopyon can vary from a few hours to 3 days. Sometimes it can be difficult to determine the particulate nature of the hypopyon. The hypopyon resolves within a few days but can be delayed up to 6 weeks. In instances where an AC tap was performed, the smear showed triamcinolone crystals with scanty cellular reaction. It is important to differentiate this from an infectious or sterile hypopyon. The differentiating features include the rapidity of onset, crystalline nature of hypopyon, absent/ sparse inflammation and spontaneous resolution. Early removal is unnecessary because of lack of evidence of endothelial or trabecular damage. Close observation for worsening is a must to rule out infectious/mixed endophthalmitis in the setting of compromised ocular immune response.