Foreign body in the Eye
Foreign object in the eye is something that enters the eye from outside the body.
It can be anything that does not naturally belong there , .and may include a speck of dust, wood chip, metal shaving, grass clipping,
insect or a piece of glass. Most foreign bodies are found under the eyelid or on the surface of the eye. When a foreign object enters the eye it will most likely affect the cornea or the conjunctiva.
It can be EXTRA OCCULAR: Lid, sclera conjunctiva cornea or
It can be INTRAOCCULAR: Angle of the anterior chamber, iris lens, Vitreous, Retina.
Find the anatomy of the eye by clicking here
MORBID ANATOMY:
The cornea is a clear doom that covers the front surface of the eye. It serves as a protective covering from the front of the eye. Light enters the eye through the cornea. It also helps to focus light on the retina at the back of the eye.
The conjunctiva is the thin mucous membrane that covers the sclera, or the white of the eye. The conjunctiva runs to the edge of the cornea. It also covers the moist area under the eyelids.
A foreign object that lands on the front part of the eye can not get lost behind the eye ball, but they can cause scratches on the cornea. These injuries usually are minor. However some types of foreign objects can cause infection or damage the vision.
Causes of Foreign Bodies in the eye.
( FOREIGN OBJECTS THAT ENTER THE EYE AT HIGH RATE OF SPEED PAUSE THE HIGHEST RISK OF INJURY)
Many foreign objects enter the conjunctiva of the eye as a result of mishaps that occur during everyday activities. The most common types of foreign object in the eye are ;
- Eye lashes,
- Dried mucous
- Sawdust
- Dirt
- Sand (Dirt and sand fragments typically enter the eye because of wind or falling debris)
- Sharp materials like metal or glass can get into the eye as a result of explosions or accidents with tools such as harmers, drills or lawn mowers.
- Cosmetics
- Chemicals
- Contact lenses
- Metal particles
- Glass particles
Signs and Symptoms of foreign bodies in the eye.
- A feeling of pressure or discomfort
- A sensation that something is in your eyes.
- Patient rubs to dislodge the object
- Eye pain
- Extreme tearing
- Pain when you look at light
- Excessive blinking
- Redness or bloodshot eye
- For penetrating foreign bodies a discharge of fluid or blood from the eye can be seen
Treatment ( EMERGENCY MANAGEMENT)
- Wash your hands
- Look at the affected eye in an area with a bright light
- Do not or put pressure on the eye
- Do not use utensils or implements such as tweezers or cotton swabs on the surface of the eye
- Do not remove contact lenses unless there is sudden swelling or you have suffered a chemical injury
- Restrict eye movement
- Bandage the eye using a clean cloth or gauze
- If the object is too large to allow for a bandage cover the eye with paper cap
- Cover the un injured eye ( this will help prevent eye movement in the affected eye)
- Refer the patient to hospital
HOSPITAL MANAGEMENT:
- Anesthetic drop will be used to numb eye surface
- Fluorescent dye , which glows under special light will be applied to eye via an eyedrop .
- The dye reveals surface objects and abrasions
- The opthalmolgist will use a magnifier to locate and remove any foreign objects.
- The objects may be removed with a moist cotton swab of flushed with water.
- If the initial techniques are unsuccessful at removing the object the ophthalmologist may use special instruments to remove it.
- If the foreign object has caused corneal abrasions, the ophthalmologist will give an antibiotic ointment to prevent infection
- For larger corneal abrasions eye drops containing cyclopentolate or homatropine may be administered to keep the pupils dilated.
- Painful muscle spasms could occur if the pupil constrict before cornea heals.
- Acetaminophine to treat pain from larger corneal abrasions
- A CT Scan or another imaging study may be required for further investigation for an intra ocular objects
Prevention
- Wearing protective eyewear or safety glasses when doing activities that could involve airborne objects.
To prevent getting a foreign body in the eye always wear protective eye wear when :
- Working with saws, harmers, grinders or power tools
- Working with dangerous or toxic chemicals
- During welding
NB:
If foreign body is chemical it incorporates in the cornea and inflammatory reaction takes place.
Some foreign body in the conjunctiva gets stuck in the conjunctiva and irritate .
On the anterior chamber: If the foreign body can sink deep in the angle viewed by a gonioscope If the iris torn a small blood may appear around the foreign body as well as in the Anterior chamber causing Iritis .
Complications of foreign bodies in eyes
Most injuries from a foreign body in the eye are minor and usually heal without further problems given the right care. Possible complications include:
- infection and scarring – if the foreign body is not removed from the eye, it may lead to infection and scarring. For example, metal objects react with the eye’s natural tears and rust forms around the metal. This is seen as a dark spot on the cornea (the clear window at the front of the eye) and can cause a scar that may affect vision.
- corneal scratches or abrasions – a foreign body may scratch the cornea, which is the clear membrane on the front of the eye. Commonly, the foreign body is trapped under the upper eyelid. In some cases, however, they can lead to a long-term problem known as recurrent corneal erosion, which may occur even years after the original injury
- ulcer – sometimes a scratch on the cornea doesn’t heal. A defect on the surface of your eye (ulcer) may form in its place. This could affect your vision or lead to an abscess
- penetration of the eye – sometimes a projectile object can pierce the eye and enter the eyeball, causing serious injury and even blindness
- corneal scarring – this can cause some degree of permanent visual impairment.