Ocular foreign body
Ocular foreign bodies are caused by flying debris. These are most often the result of workplace accidents (welding) or domestic accidents (gardening). The foreign body can become lodged under the eyelid, on the cornea, and, more rarely, penetrate the eye. It is essential to consult a doctor to assess the extent of the injury, remove the foreign body, and prevent any potential infection. This constitutes a true ophthalmological emergency .
What is an ocular foreign body?
Foreign bodies in the eye are most often caused by a projectile. This can be due to a workplace accident, such as the use of an angle grinder or a soldering iron, or to a domestic accident, particularly while gardening.
A splinter measuring a few millimeters lodges under the eyelid or on the cornea and exceptionally inside the eye.
Without prompt removal and treatment, there is a risk of infection with visual sequelae.
Who is affected?
Foreign bodies mainly affect construction workers, mechanics, weekend handymen and users of 2 wheels.
One thing they have in common is the absence of appropriate protective glasses or visors.
How to react in case of a foreign object
Removing a foreign object yourself, even if it's visible to the naked eye, is not recommended, as it could penetrate deeper into the cornea. Waiting for it to disappear on its own by performing eye washes is also a painfully unrealistic dream.
If you have a foreign body in your eye, it's best to consult a doctor immediately. If an ophthalmologist isn't available right away, ask the pharmacist for vitamin A ointment to instill into the eye, close the eye, and wait for your urgent appointment.
Removal of the foreign body
The removal of a corneal or subpalpebral foreign body is done under local anesthesia, after instillation of a few anesthetic drops.
The ophthalmologist removes the foreign body using a sterile needle or a microsponge (sterile cotton swab).
Preventive treatments for a possible secondary infection should then be started for 5 to 7 days:
Regular eye washes with saline solution
Antiseptic or antibiotic eye drops 3 to 4 times a day
Moisturizing eye drops for comfort, 4 to 12 times a day
Healing ointment 4 to 6 times a day for the first 2 days then only in the evening.
How to treat pain after removal of a foreign body?
After the foreign body is removed, the local anesthetic will wear off and the sensation of discomfort/pain will return. This is due to the keratitis (a type of scratch) caused by the removed foreign body. Therefore, there's no need to return to the ophthalmologist to tell them that they left pieces behind; the sensation is related to the residual scratch.
To manage the pain, it is recommended to apply vitamin A ointment and cover the eye with adhesive tape. In cases of persistent, intense pain, a cold compress can be applied to the eyeball for pain relief, and Paracetamol + Codeine may be prescribed.
Complications of foreign bodies
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Superficial foreign bodies in the eye tend to develop into secondary infections if not removed. At best, it may be a simple case of conjunctivitis , but more often the situation degenerates into a corneal abscess !
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This is a serious infection of the ocular surface that can lead to the loss of the eye.