A 54 year old male presents with complaints of a foreign body sensation in his left eye. Which of the following is an indication for urgent ophthalmologic referral?
1) You note an intraocular pressure of 20 in the affected eye
2) You discover a moderate-sized linear corneal abrasion
3) You note a small puncture wound in the globe
4) Your examination reveals a metallic foreign body that is loosely adherent to the white of the eye