Ocular trauma is the leading cause of acquired monocular blindness, accounting for 1.97–6% of such cases. Particularly, penetrating ocular injuries are among the most common eye injuries with this kind of outcome. Early diagnosis and prompt management are crucial to avoid complications and the especially dreaded enucleation. In this article, the authors describe the clinical management and evaluate the visual and anatomical results obtained in a case of ocular injury with retained intraocular foreign body in a 20-year old female patient. The course of treatment involved a combination of penetrating keratoplasty with a temporary keratoprosthesis, phacoemulsification with intraocular lens implantation and pars plana vitrectomy. At three years from the initial injury, the patient was able to count fingers at 30 centimetres and anatomical restitutio ad integrum of the globe had been achieved.