Eye injuries - foreign body in the eye

About foreign bodies in eyes

A foreign body is an object in your eye that shouldn’t be there, such as a speck of dust, a wood chip, a metal shaving, an insect or a 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 of getting a foreign body in the eye are tradespeople such as labourers, woodcutters, fitters and turners, boilermakers, people hammering metal on metal, gardening and using motorised tools. Don’t try to remove a foreign body from your eye yourself. Go straight to your GP (doctor), optometrist or the nearest hospital emergency department for help.

Symptoms of foreign bodies in eyes

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).

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 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 (the clear window at the front of the eye) and can cause a scar that may affect your vision. Once it is removed, symptoms should improve
• 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. 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 or lead to an severe infection
• penetration of the eye – sometimes a projectile object can pierce the eye and enter the eyeball, causing serious injury and even blindness
• corneal scarring –can cause permanent visual impairment.

Treatment of foreign bodies in eyes

Medical treatment generally includes:

• The doctor or nurse checks your vision.
• Once they find the foreign body, they gently remove it after numbing the eye with anaesthetic eye drops. If it’s central or deep, they will arrange for you to see an ophthalmologist (specialist eye doctor) to have it removed.
• Your eye may be washed with 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 or orbit.
• Your eye may be patched to allow it to rest and any scratches to heal. Patching the eye is not necessary, however some still do
• You must not drive until the eye patch is removed and your vision has returned to normal.
• Your doctor may 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
• If there are any serious problems, or a residual rust ring, you will be sent to an ophthalmologist.

Eye drops and ointments

General suggestions on how to use eye drops and ointments include:

• 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.
• Continue with the treatment until your eyes have healed.
• Store all drops and ointments as instructed on the box or container and keep them out of reach of children.
• Some drops contain drugs or preservatives that damage contact lenses. Do not wear contact lenses until instructed by your doctor.

When to seek urgent medical help for foreign bodies in eyes

See your doctor or go to the emergency department of your nearest hospital if:

• you still have marked pain and watering after the object has been removed, there will be some discomfort while the eye is healing
• you have visual disturbance
• clear or bloody fluid is coming from your eyeball
• you are concerned for any other reason.

Self-care at home after treatment for foreign bodies in eyes

Be guided by your doctor, but suggestions include:

• You must not drive with an eye patch on – it can be very difficult to judge distances properly.
• You may take the patch off – usually the next day, or as instructed by your doctor.
• If you have some discomfort in the eye, you can take pain-relieving medication that contains paracetamol or ibuprofen. Follow the instructions on the packet carefully.
• 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.

Prevention of foreign bodies in eyes

The best way to prevent a foreign body from getting in your eye is to protect your eyes.

Suggestions include:

• Always wear safety glasses when working in dusty or windy areas, and especially when working in a place where flying debris is likely.
• Use safety glasses or goggles with close-fitting side shields. Regular sunglasses or corrective glasses are not enough.
• Don’t stand or walk near anyone who is grinding, drilling, hammering, using lawn mowers and other gardening tools
• Wear safety glasses when playing some sports such as tennis or squash.

Where to get help

• In an emergency, call triple zero (000)
• Emergency department of your nearest hospital
• Your GP (doctor)
• Ophthalmologist
• Your manager or supervisor
• Your elected occupational health and safety (OH&S) representative and your workplace OH&S coordinator
• WorkSafe Victoria. Tel. (03) 9641 1555 or 1800 136 089 (toll free) – for general enquiries
• WorkSafe Victoria Emergency Response Line Tel. 13 23 60 – to report serious workplace emergencies (24 hours, 7 days)