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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:

c -- Perform a complete dilated eye exam on both eyes, consider a diagnostic ultrasound, and take the patient to the operating room immediately. This patient has a corneal laceration with iris plugging the wound. Although this may resemble a corneal foreign body or pigmented limbal lesion, this is incarcerated iris tissue which must be repaired surgically.  Given the patient’s history and occupation, it is important to completely examine BOTH eyes and rule out a potential intraocular foreign body.