Foreign Body Removal, Cornea
A corneal foreign body is an object (eg, metal, glass, wood, plastic, sand) either superficially adherent to or embedded in the cornea of the eye. The removal of a corneal foreign body is a procedure commonly performed in the clinic or emergency department setting.1 If corneal foreign bodies are not removed in a timely manner, they can cause prolonged pain and lead to complications such as infection and ocular necrosis.
An intraocular foreign body penetrates into the anterior chamber of the eye or into the globe itself. It is likely to cause significant morbidity and, thus, necessitates a through workup, including, in many instances, a detailed ophthalmologic evaluation with imaging such as plain radiography or CT scan of the orbits.2 Though MRI is occasionally used, it is contraindicated if a metal foreign body is suspected. The patient’s description of the circumstances of the injury is the most crucial element in determining the likelihood of globe penetration, which would necessitate referral to an ophthalmologist.3, 4 An intraocular foreign body does not necessarily change visual acuity.
For a Medscape CME activity on ocular examination, see Examining the Eyes of an Older Person.
Additional resources regarding corneal conditions can be found at the Medscape Cornea and External Disease Resource Center.
Foreign body on the cornea
Patients who present to the emergency department with emergent conditions should be referred to an ophthalmologist on the day of presentation. Patients with urgent conditions can be seen the following day.
Hyphema (blood in the anterior chamber)
Diffuse corneal defect or opacity
Laceration of the cornea or sclera
Single dilated pupil or an abnormally shaped pupil
A more deep or shallow anterior chamber (when compared to the other eye)
Possible penetration of the globe
Multiple foreign bodies
Extremely uncooperative patient (eg, young child, intoxicated individual, patient with mental disability)
Significant lid edema
Diffuse subconjunctival hemorrhage