Foreign Body In Eye

What Is It?

Eyelashes prevent most particles or objects from entering the eye, and tears usually are able to rinse out particles that do get in the eye. Occasionally, a solid object or projectile can adhere to the eye or embed itself below the surface of the eye.

Foreign bodies in the eye can be small specks of dirt or eyelashes, or larger objects such as cinders, rust or glass. The eye is damaged easily.

The most common type of eye injury is a corneal abrasion — a scratch in the cornea, the transparent layer that lies over your pupil (the center of your eye) and iris (the colored part). If the foreign body sticks to the undersurface of the eyelid, the scratch occurs when the object rubs against the cornea as you blink, and the scratch will be in a vertical line. Alternatively the foreign particle may be stuck to the clear cornea.

Small foreign bodies on the white of the eye actually often do not cause much discomfort.

Symptoms

Symptoms can include itching, irritation or redness of the eye. If you have a corneal abrasion, you may have eye pain, light sensitivity and blurry vision.

Diagnosis

If you visit your doctor, he or she will shine a light into your eye to look for the object and may use a cotton swab to turn your eyelid up. Your doctor will examine the edges of your eye as you look in different directions. Sometimes eye drops containing a local anesthetic agent are used to make this examination more comfortable.

Your doctor should check your vision using an eye chart. If your doctor suspects that you may have a corneal abrasion, he or she can examine your eye after applying a small amount of "fluorescein" dye to the surface. Your doctor may apply the dye using a paper strip. When the strip touches your eye, a film of fluorescein will mix with your tears and float easily across the surface of your eye. Fluorescein collects in areas that are injured and glows when viewed under blue light.

Expected Duration

Some foreign objects can be removed easily and do not damage the eye. Others are more difficult to remove and can injure the eye.

With proper treatment, symptoms of a mild corneal abrasion almost always improve or disappear completely within 24 to 48 hours. For more severe abrasions, symptoms often last longer.

Prevention

Use protective eyewear at work if appropriate, such as during construction work and when playing sports. At work, protective eyewear can reduce the risk of a corneal abrasion by up to 90% because these abrasions often happen when a foreign object gets in the eye. If you play a sport, use goggles to protect your eyes from sand, dirt and other objects. If you need glasses to see clearly, you can have goggles made with prescription lenses.

If you wear contact lenses, wash your hands thoroughly before you handle the lenses, and keep your lenses clean.

Treatment

Never rub your eye to try to get the object out because this can create a corneal abrasion or deeper injury.

If the object is cannot be removed easily or if it is embedded in the eye, cover the eye with gauze and see a doctor immediately.

If you wear contact lenses, wash your hands and remove the lenses. It is possible that a small rip in the lens is causing the irritation, rather than a foreign object.

If the object is small, such as an eyelash or speck of dirt, you may be able to see it by opening the eye as wide as possible. Have someone look at your eye or, if you are by yourself, look in a mirror. Hold down your lower lid and look up, then lift your upper lid and look down. If you can see the object, you can remove it with the edge of a facial tissue or a moistened cotton swab.

For small objects you also can try rinsing your eye with clean water. Sometimes your lashes will lift the object out if you pull your upper eyelid over your lower one. If neither of these methods removes the object, try getting someone to help. Lie on your side and hold your eye open with your fingers. Have your friend rinse the eye with an eyedropper or small cup filled with warm water or sterile saline solution.

If you cannot remove the object, bandage your eye loosely and see a doctor. Your treatment at the doctor's office depends on what the object is, where it is and whether it has damaged your eye. If you have a corneal abrasion, your doctor may give you antibiotics (eye drops or ointment) to prevent infection. Your doctor does not prescribe anesthetic-containing eye drops, although he or she may use them during your examination. Although these eye drops make your eye feel better, they also prevent you from feeling pain that may indicate a more serious problem.

When To Call A Professional

A puncture wound in the eye is a medical emergency. If you have a foreign object that may be embedded beneath the eye surface, see a physician immediately.

The eye is easily damaged, so you should see a doctor if:

• You think you have removed the object but still have pain, irritation or blurred vision.
• You cannot remove the object yourself or with the help of someone else.

Prognosis

The outlook depends on what type of object is in the eye and how it got there. Most corneal abrasions heal within 48 hours. Glass shards, other sharp objects and objects that entered the eye at high speed are more likely to cause damage. An object that penetrates the eye may lead to severe vision loss.

Additional Info

American Academy of Ophthalmology
http://www.aao.org/

National Eye Institute
http://www.nei.nih.gov/

American Academy of Family Physicians (AAFP)
http://www.familydoctor.org/