Posted by: juliegriffey | June 12, 2011

Optical Foreign Bodies – also Known as Stuff that Gets Stuck in Your Eyes

rubbing eyesMy husband, Richard, is an ER doc (and the son, grandson and brother of ophthalmologists) so he has a bit of medical  and optical knowledge – growing up working in his dad’s office and now seeing patients with eye emergencies.  In the car, especially on long drives, Richard likes to give (what I like to call) spontaneous, medical lectures.  It doesn’t matter if I am listening or not.  I have been lectured on everything from neurons in our brain to how the heart works.  And while I may be a bit smarter for it, sometimes I just want to tell him: “shut up and let me read/listen to music/have silence/do anything else but listen to this!” Finally – after nine years of marriage – on a 20 hour drive from Vermont to St. Louis – I’ve figured out a way to use these lectures to my advantage; have him talk about issues related to the eye – and voila – my weekly blog entry will be written.  So here is the first of what I am sure is to be many more (as I plan to be married to this guy for a while) spontaneous medical lectures related to the eye by Dr. Richard (my husband).

Occasionally people get things in their eyes – anything from dust, wood, sand or metal. And, most nothing of the time, nothing happens. Either your eyelashes sweep the foreign body away or your eye tears up and flushes it out naturally.

However, if you get a foreign body in your eye, you should wash your eye out with water immediately and see if it clears on it own. If this does not seem to work and you have a persistent sensation of a foreign body in your eye, then there is a good chance something is indeed in your eye and it may be causing you a corneal abrasion and you should get seen by your eye doctor immediately.

An eye doctor will follow a procedure to assess the situation.

1) Is there a foreign body?

Determining whether there is a foreign body requires an eye exam. The doctor will examine the eye, sometimes flipping the lid to find the foreign body. To remove the foreign body, the doctor will numb the eye and then use a “hockey stick” or a “spud” or even a needle (if no other appropriate instruments are available) to fish it out.

Metal ocular foreign bodies may require additional work as they can produce rust rings in the eye which can be removed with a burr. If rust rings are not removed they will cause a stain on the eye.

2) Is there a corneal abrasion present?

An ocular foreign body can cause a scratch on your cornea which is called a corneal abrasion.  A persistent piece of matter stuck in your eye will cause pain and when you rub your eye, you can get an abrasion. Or, when a foreign body gets stuck under your eyelid and you blink, the foreign body scratches up and down your eye causing a linear corneal abrasion.

Corneal abrasion heal very quickly but can be very painful. They also but you at an increased risk of an infection, especially if you wear contact lenses.

To determine if there is a corneal abrasion, the doctor will numb the eye using a drop like tetracaine and examine the eye with a slit lamp which helps detect depth and size and to make sure there is not something more concerning. A high impact foreign body can cause even more damage. If the foreign body has gone deeper – it may require an x-ray or fluorescein strip test and UV light. The way this works is that if there is a corneal epitheial defect then there is increased uptake of fluorescein.

3) is there now an infection on top of that?

The incidence of corneal abrasions becoming infected are low. Typical treatment is a topical antibiotic (something like erythromycin,bacatracin or polymixn) – helps prevent infection and can also be soothing.

Follow up is always recommended with and eye doctor to make sure the corneal abrasion and infection is healing. Most heal in a couple of days but it depends on the depth and size.  The best way to prevent ocular foreign bodies, corneal abrasions and subsequent infections is to wear protective eyewear when your are in situations where particles are in the air.

So there you have it – Dr. Richard’s take on ocular foreign bodies.  On a different note – I tried getting some material from my ophthalmologist father-in-law Dr. Tom while we were on vacation with him last week. He claims he has already given me his best material and had nothing for me! JEEEEEEZZZZ! 40 years of practice and you got nothing!  Thank goodness his son is so verbose…

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Responses

  1. I know a woman who recently splashed bleach in her eye. She flushed it with water at home & went to the ER afraid she had damaged her vision. The bleach had caused a corneal abrasion and the doctor gave her a tube of erythromycin to apply just like your post says!

  2. Mostly when you get infection in your eyes it is because of the foreign body attack this foreign body can be in the form of dust,or any other substance.


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