Eye Injury/ Foreign Bodies
Eye Injuries
S05.9 + (Y34.99)
Many foreign objects that enter the conjunctiva are the result of mishaps that occur during everyday activities e.g. eyelashes, dust, dirt, sand.
Foreign objects that enter the eye at high rate of speed pose the highest risk of injury and may embed in the eye especially the cornea, or may penetrate into the eyeball. This often follows welding, grinding or hammering metal without wearing a protective eye visor or spectacles.
DESCRIPTION
- Disturbance of vision.
- Complaints of foreign body in the eye that may not be visible.
- Pain and lacrimation.
- Metallic foreign body embedded in the cornea appears as a cloudy spot with a dark speck (the metal splinter) in the centre.
GENERAL MEASURES
- If the foreign body is not embedded, irrigate eye with sterile water or sodium chloride 0.9%.
- Remove any foreign body if visible on sclera or conjunctivae with a moist cotton bud.
- Stain with fluorescein to reveal corneal foreign body if it is not obvious.
- Consider X-ray of orbit (with frontal and lateral views) to exclude intra-ocular metallic foreign body if the mechanism is projectile in nature.
MEDICINE TREATMENT
Local anaesthetic if needed:
- Tetracaine 1% eye drops, instil 1 drop in the affected eye(s), before removal of the foreign body.
- Apply an eye shield until the anaesthetic effect wears off.
- Never give anaesthetic drops to the patient to take home.
LoE:III
Prophylactic antibiotics:
- Chloramphenicol 1%, ophthalmic ointment, applied 6 hourly for 5 days.
LoE:III6
REFERRAL
- Any embedded or penetrating foreign body.
- Failure to remove a visible foreign body.
- Suspected intraocular foreign body.
Standard Treatment Guidelines and Essential Medicines List for South Africa, Primary Healthcare, 2020-2024_Version 1.0_30 September 2024
Chapter 18: Eye Conditions_18.3 Eye Injuries_18.3.2 Eye Injury, Foreign Bodies