Objective:

To report a case of a 13-year-old girl with recurrent anterior uveitis ultimately found to have an eyelash lodged in the anterior chamber angle.

Approach:

• Case Presentation: A 13-year-old girl presented with redness, pain, and decreased vision in her right eye for 3 months, initially diagnosed with HLA-B27–associated anterior uveitis.
• Diagnosis and Treatment: She tested positive for HLA-B27 and was treated with corticosteroids and immunosuppressive therapy, but uveitis recurred 4 times.
• Surgical Intervention: Surgery revealed an eyelash in the anterior chamber angle, which was removed, leading to resolution of inflammation.

Key Findings:

• The eyelash was associated with 4 episodes of uveitis over 3 months.
• Best-corrected visual acuity improved from 20/250 to 20/33 after removal of the eyelash, and to 20/20 at 2 years.
• HLA-B27 positivity does not exclude other causes of ocular inflammation.

Interpretation:

Intraocular eyelashes can cause variable inflammatory responses, and a negative trauma history does not rule out the presence of an intraocular foreign body.

Limitations:

• The case is a single report and may not represent broader trends.
• Further studies are needed to understand the full range of inflammatory responses caused by intraocular foreign bodies.

Conclusion:

Repeat examination and ultrasound biomicroscopy are recommended when an anterior-segment foreign body is suspected.

Sources:

• Case Reports in Ophthalmology