REMOVAL PROCEDURE OF FOREIGN BODY IN THE CORNEA

T . SITI HARILZA ZUBAIDAH

Foreign body• Any particle or material gets into eye.

• Superficial or penetrating.

• Metal particle, glass, wood, sand, dust particle.

• Incidence don’t vary according to sex.

How do you get ? Superficial : - stick.

- trapped. - do not enter the eye.

May occur when working under a car or when outside on a windy day.

Not usually serious.

• Penetrating : - penetrate. - enter the eye.

• Most occur during the act of grinding or hammering.

• Extremely serious.

Signs/Symptoms Sharp pain followed by burning, irritation and

tearing.

Foreign body sensation.

Blurred vision.

Conjunctiva injection.

Mild upper lid edema.

What does it feel like

• Superficial : very uncomfortable, cause eye irritation leading to reddish and watery eye.

• If it stuck beneath the upper eyelid, pain will go on increasing every time the eye closes.

• Penetrating : less pain although much more serious injuries.

• The vision maybe reduced, but not always.

Evaluation• Visual acuity.

• History of injury.

• Observe for foreign object.

• Evert the lids.

How to remove?

• Apply topical anesthetic.

• Position the patient in the slit lamp.

• Ensure that his chin is in the chin rest and his head is against the head rest.

Provide a fixation target for his opposite eye that positions his affected eye in the slit lamp microscope light beam.

Remove corneal foreign body with a moistened cotton tipped applicator if possible.

If this does not eliminate the foreign body then 25 gauge needle can be used with caution.

Medical treatment Corneal abrasions give antibiotic eye drops or

ointment.

Abrasion > 50% treated with a patch.

Any noted damage to the iris, the lens or the retina requires immediately evaluation by ophthalmologist and may or may not require surgery.

• A ruptured eyeball requires surgery by an ophthalmologist.

• If hyphaema noted requires close follow-up care with an ophthalmologist.

PREVENTION

• Eye protection : - the best prevention. - always wear when working. - should cover all.