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CASE REPORT
Delayed presentation of severe ocular injury from a button battery
  1. G Ratnarajan1,
  2. D Calladine1,
  3. K J Bird2,
  4. S L Watson1
  1. 1Department of Ophthalmology, Royal Berkshire NHS Foundation Trust, Reading, Berkshire, UK
  2. 2Department of Anaesthetics, Royal Berkshire NHS Foundation Trust, Reading, UK
  1. Correspondence to Dr Gokulan Ratnarajan, g.ratnarajan{at}gmail.com

Summary

A 2-year-old girl presented to the emergency department at 3:00 h with severe pain in her right eye and a rust coloured, blood stained frothy discharge that had woken her. An examination of her eye revealed a shiny metallic looking foreign body, which was immediately removed by the on-call ophthalmologist. That morning the patient underwent ocular examination under anaesthesia and was found to have severe tissue necrosis resulting from an electrochemical burn. She was treated with daily rodding for 3 days and betamethasone ointment four times a day, which was gradually tapered. At 3 months her only eye pathology was a mild symblepharon between the bulbar and tarsal conjunctiva. This is the first case of delayed symptoms after placement of a button battery into the conjunctival fornix. This case highlights the serious nature of button battery injuries to the eye and the potential to miss the diagnosis owing to a delayed onset of symptoms.

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