Eye injuries - foreign body in the eye

A foreign body is an object in your eye that shouldn’t be there, such as a speck of dust, wood chip, metal shaving, insect or piece of glass. The common places to find a foreign body are under the eyelid or on the surface of your eye.

Those most at risk are trades people such as labourers, woodcutters, fitters and turners, and boilermakers. Don’t try to remove a foreign body yourself. Go straight to your doctor or the nearest hospital emergency department for help.

Symptoms
The symptoms of a foreign body in the eye include:

• Sharp pain in your eye followed by burning and irritation
• Feeling that there is something in your eye
• Watery and red eye
• Scratchy feeling when blinking
• Blurred vision or loss of vision in the affected eye
• Sensitivity to bright lights
• Bleeding into the white of the eye (subconjunctival haemorrhage).

• Infection and scarring – if the foreign body is not removed from your 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 (or clear window) of the eye and can cause a scar that may affect your vision. Once it is removed, symptoms should quickly ease.
• Corneal scratches or abrasions – a foreign body may scratch the cornea, which is the clear membrane on the front of the eye. With the right care, most corneal abrasions – even large ones – heal within 48 hours. 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.
• Penetration of the eye – sometimes an 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 loss.

• The doctor or nurse checks your vision.
• Once they find the foreign body, they gently remove it. If it is central or deep, they will arrange for you to see an ophthalmologist (specialist eye doctor) to have it removed.
• Your eye may be washed in saline (sterile salt water) to flush out any dust and dirt.
• X-rays may be done to check whether an object has entered your eyeball.
• Your eye is patched to allow it to rest and any scratches to heal.
• Your doctor will want to see you again to check that your eye is healing and that your vision is all right. You should not miss this appointment. Even though you may feel better, your eye may not have fully healed. The follow-up is needed to make sure the treatment is working.
• If there are any serious problems, or a residual rust ring, you will be sent to an ophthalmologist.

• Don’t drive with an eye patch on – it can be very difficult to judge distances properly.
• You may take the patch off – usually after about two hours for a foreign body or on the next day for a corneal ulcer or abrasion, or as instructed by your doctor.
• You may have some discomfort in the eye. Take a painkiller that contains paracetamol. Check the packet for instructions.
• Avoid working with machinery or at heights.
• You may be advised to use drops or ointment to stop infection. Follow your doctor’s advice as to how often to put them in. You will need to continue the treatment until your eye has healed.

• Wash your hands before touching your eyes.
• Rest your finger on your cheek and pull down the lower eyelid.
• Tilt your head back and drop the liquid in behind your lower eyelid.
• For ointment, smear a small amount along the inside of the lower eyelid. Make sure that the nozzle doesn’t touch the eye. Generally drops are used during the day and ointment at night.
• You need to continue with the treatment until your eyes have healed.
• Keep all drops and ointments in the fridge and out of reach of children.
• Some drops contain drugs or preservatives that damage contact lenses. If you wear contact lenses, you should take them out.

• You still have marked pain and watering after the object has been removed
• Your vision is blurry when you take the patch off, or there are other vision changes such as blind spots or seeing ‘stars’
• Clear or bloody fluid is coming from your eyeball
• You are concerned for any other reason.

• Always wear safety glasses when working in dusty or windy areas, and especially when working in a place where flying debris is likely.
• The safety glasses or goggles should be close fitting with side shields. Regular sunglasses or corrective glasses are not enough.
• Don’t stand or walk near anyone who is grinding or drilling.
• Wear safety glasses when playing some sports such as tennis or squash.
• If you do get something in your eye again, wash your eye with water or saline. Don’t try to remove a foreign body yourself. Go straight to your doctor or the nearest hospital emergency department for help.

• Doctor
• Emergency department of your nearest hospital
• Ophthalmologist

• A foreign body is an object in your eye that shouldn’t be there, such as a speck of dust, wood chip, metal shaving, insect or piece of glass.
• Don’t try to remove a foreign body yourself – go straight to your doctor or the nearest hospital emergency department for help.
• With the right care, most injuries heal without further problems.

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