Goals

To remove foreign bodies superficially adhered to the conjunctiva or cornea or embedded in the cornea in a timely manner to relieve pain and prevent infection and ocular necrosis.

Background

The cornea is the transparent, outer most layer of the eyeball. The cornea covers the iris and pupil and plays a role in focusing incoming light rays to the retina. The cornea is protected by the eyelids, but is susceptible to injury, especially from trauma. A corneal abrasion is the result of superficial or deep loss of the top layer of the corneal epithelium due to scratching or cutting by a foreign body. Foreign bodies may be present on the cornea or adhered to the conjunctiva of the upper or lower lid. Symptoms of a foreign body to the eye include pain, blurred vision, tearing, and foreign-body sensation. Patients with a corneal abrasion present similarly to those with a foreign body of the eye. Complications of removal of a foreign body from the eye include incomplete removal or rust ring, conjunctivitis, and perforation of the cornea.

Contraindications

The following situations warrant urgent ophthalmology referral:

• Penetrating trauma
• Intraocular foreign body (penetration of the anterior chamber or into the globe)
• Multiple foreign bodies
• Nonreactive or an irregular pupil
• Suspected infectious infiltrate (opacity of the cornea)