Eye injury/foreign bodies

S05.9+(Y34.99)

Many foreign objects that enter the conjunctiva are the result of mishaps that occur during everyday activities e.g. eyelashes, dust, dirt, sand.
Foreign objects that enter the eye at high rate of speed pose the highest risk of injury and may embed in the eye especially the cornea, or may penetrate into the eyeball. This often follows welding, grinding or hammering metal without wearing a protective eye visor or spectacles.

DESCRIPTION

  • Disturbance of vision
  • Complaints of foreign body in the eye that may not be visible
  • Pain and lacrimation
  • Metallic foreign body embedded in the cornea appears as a cloudy spot with a dark speck (the metal splinter) in the centre.

GENERAL MEASURES

  • If the foreign body is not embedded, irrigate eye with clean water or sodium chloride 0.9%.
  • Remove any foreign body if visible on sclera or conjunctivae with moist cotton bud.
  • Stain with fluorescein to reveal corneal foreign body if it is not obvious.
  • Consider X-ray of orbit to exclude intra-ocular metallic foreign body.

MEDICINE TREATMENT

Local anaesthetic if needed:

  • Tetracaine1% eye drops, instil 1 drop in the affected eye(s), before removal of the foreign body.
    • Apply an eye shield until the anaesthetic effect wears off.
    • Never give anaesthetic drops to the patient to take home.

LoEIII

REFERRAL

  • Any embedded or penetrating foreign body.
  • Failure to remove a visible foreign body.
  • Suspected intraocular foreign body.