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Foreign body in the eye

What is a foreign body in the eye?

It is any particle such as dirt, metal or sawdust that lodges on the surface of the eye or inside the eye. The main causes are dust carried by wind, metal fragments from grinding, and wood particles from drilling or cutting.

What are the different types of foreign body?

• A corneal foreign body is on the clear surface of the eye.
• A conjunctival foreign body is on the skin of the eye, especially under the eyelids.
• An intraocular foreign body is inside the eye (a very serious problem).

What are the symptoms?

The main symptoms are eye pain or discomfort, watery eye, blurred vision, redness in the white of the eye and sensitivity to bright light. These may occur straightaway or, more commonly, after about 8 hours. The symptoms are usually worse for an intraocular foreign body, but can be surprisingly mild at first. If you are in doubt, it is better to err on the side of safety and go to your doctor.

Who gets foreign bodies in the eye?

Anyone can, although it tends to be commonest in young adults. Those at most risk are tradespeople such as boilermakers, woodcutters, fitters and turners, and labourers.

What are the dangers?

• The biggest danger is an intraocular foreign body, which can be missed if not suspected. It is diagnosed by X-ray of the eye.
• The main problem with metal on the cornea is rusting, which causes a dark spot on the clear part of the eye and can cause a scar, which affects vision.
• Infection is a problem, especially if you use unsterile drops in the eye.

What should you do?

If you get a foreign body in your eye, go to your doctor as soon as possible. It is easier to remove and has less chance of rusting if you attend early.

What is the treatment?

The doctor will usually check your vision and examine your eyes. The foreign body will be located (however, sometimes it comes out before this but still feels as though it is in the eye). Since the eye is very sensitive to pain, the doctor will usually put some local anaesthetic drops into the eye to make removal comfortable.

The foreign body will be removed with either a cottonwool bud or, if it is stuck in the cornea, with a needle.

What is the follow-up treatment?

If a metal foreign body has been removed from the cornea, some eye drops will be placed in the eye. The drops should be put in regularly as directed by your doctor.

Then an eye pad or patch will be placed over the eye. It is important to keep this pad on, because it allows the small defect in the cornea to heal. Once the local anaesthetic wears off (about 5 minutes), you will have some discomfort in the eye. This can be relieved by taking aspirin or paracetamol. You should not drive with an eye patch on.

You should come back for review as specified by your doctor.

The eye will not heal in less than 48 hours after removal of the foreign body.

How can foreign bodies be prevented from entering the eye?

Wear good eye protection, preferably close-fitting plastic eye glasses with protective sides. Do not walk or stand close to someone who is grinding or drilling. Have eye protection in a dusty, windy area.

Copyright 1995: John Murtagh, Professor of General Practice
Monash University, Melbourne, Australia