II. Causes
- Work related particles (drilling, Sanding)
- Environmental (Sand, Dirt)
III. Symptoms
IV. Exam Techniques
- Inferior Cul-de-sac foreign body
- Patient looks up while lower lid pulled down
- Superior Cul-de-sac foreign body (Most common)
- Elevation of upper lid while patient looks down
- Usually not effective at visualizing foreign body
- Upper Eyelid Eversion
- Elevation of upper lid while patient looks down
V. Signs
- Check Visual Acuity
-
Fluorescein stain
- Helps localize foreign body (sand or other particle)
- Pinpoint dye uptake
- Helps localize secondary Corneal Abrasions
- Helps localize foreign body (sand or other particle)
- Foreign body (usually on superior Conjunctiva)
- Carefully examine small sulcus under lid margin
- Frequent site of missed foreign body
- Carefully examine small sulcus under lid margin
-
Corneal Abrasions
- Superior cul-de-sac foreign body
- Multiple vertical linear abrasions
- Confined to one quadrant of superior Cornea
- Superior cul-de-sac foreign body
VI. Management
- Removal of foreign body
- Irrigation
- Cotton swab moistened with Topical Anesthetic
- Sweep across lid Conjunctiva at foreign body site
- If no foreign body found
- Sweep both lid Conjunctivae with moist cotton swab
- May remove overlooked foreign body
- Indications to refer to ophthalmology
- Persistent symptoms (esp. glass fragment exposure)
- Difficult removal of foreign body
- Deep Laceration associated with foreign body