X-ray turns a blind eye to ferrous metal.

The case is reported of a 31-year-old man with a retained metallic intraocular foreign body (IOFB) in the left eye who underwent magnetic resonance imaging (MRI) for investigation of a subsequent unrelated brachial plexus injury Despite the patient providing good history of IOFB, the decision to proceed with MRI was based on screening orbit X-ray which was reported as normal. A review of published reports regarding screening recommendations for MRI for patients with IOFB is provided. A minimum recommendation is for prescreening questionnaire; belief of the patient history is critical. If there is any doubt after history and examination by an ophthalmologist, then computed tomography imaging of the orbits is recommended. Whether screening by plain X-ray imaging is worthwhile is debatable as the sensitivity and specificity of this modality is poor.