Cornea (non-perforating foreign bodies)

Consult expert advice.

• foreign bodies may impact on the cornea during drilling, hammering or grinding. The eye is painful, photophobic and lacrimates profusely. Movement exacerbates the irritation
  
  
• diagnosis:
  • if a metal foreign body is suspected then xray the orbit or consider an orbital ultrasound
    
    
• removal of foreign body:
  • the eye is instilled with a drop of local anaesthetic and the foreign body removed. Various methods have been employed to remove a foreign body e.g. using a triangle of clean card, or a moistened cotton bud. If these methods do not work then a needle tip (or a special rotary drill) can be used; however great care must be taken when using these as the eye can easily be damaged. Antibiotic ointment e.g. chloramphenicol, and a cyclopegic drop e.g. cyclopentolate are then applied. The eye is covered with a pad until the epithelium has healed

Subtarsal foreign body:

• a painful eye with vertically linear corneal abrasions may indicate a subtarsal foreign body. The upper eye should be everted and the body removed. Antibiotic ointment is instilled but a pad is unnecessary

A corneal abrasion may occur secondary to injury of the epithelium covering the cornea. If this heals ineffectively then a recurrent corneal erosion may occur.