A case of an intraocular foreign body due to graphite pencil lead complicated by endophthalmitis

We report a case of an 8-year-old boy who presented with an intraocular for eign body composed of graphite pencil lead, The patient had been accidental ly poked in the right eye with a graphite pencil. Primary care consisted of corneal suturing and lens extraction. Two pieces of the pencil lead remain ed in the vitreous cavity following surgery, and 2 days later the patient d eveloped endophthalmitis. Pars plana vitrectomy was performed immediately a nd the intraocular foreign bodies were removed through the scleral wound. C ultures of the vitreous fluid revealed no bacterial organisms. X-ray fluoro scopic analysis of the vitreous detected 1 ppm of aluminum (a constituent o f the pencil lead). Although the clinical presentation indicated probable b acterial endophthalmitis, the detection of elemental aluminum within the vi treous cavity also suggested the possibility of further retinal toxicity du e to some dissolving of the pencil lead.