Corneal Foreign Body

Key history
Key examination
Initial management
Referral

Key history

• Mechanism and timing of injury (foreign body from metal striking metal may give ocular penetration
• Effect on vision

Key examination

DO

• Visual acuity in affected and fellow eye
• Note location, size, and type of foreign body – is there associated rust?

LOOK FOR

• Check that the anterior chamber and iris look normal (like the fellow eye)

Initial management

• AP and lateral x-ray of globe if suspicious of metallic intraocular foreign body
• Superficial foreign bodies should be removed with cotton bud after anaesthetic drop
• If not possible with cotton bud, peripheral foreign body removal can be attempted with 20G needle
• Chloramphenicol ointment 6 hourly for 7 days
• Eye pad if this is more comfortable
• Review in 24 hours.

Referral

Semi-urgent, only if:

• Adherent central foreign body
• Residual rust