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A 28-year-old man reports that a few days ago while working at the mechanical shop where he is employed “a piece of metal” flew into his eye.  He reports moderate pain and slightly blurred vision in that eye. On slit lamp examination, you find the above (on low and high magnification).

The most appropriate next step is:

a. Remove the metallic foreign body at the slit lamp with a needle before a rust ring occurs. b. Start topical steroids/antibiotics immediately. c. Perform a complete dilated eye exam on both eyes, consider a diagnostic ultrasound, and take the patient to the operating room immediately. d.  This is a benign pigmented limbal lesion and should be followed conservatively.

For answers to the above, click here on or after November 7, 2006.