Ocular foreign body - Revision history

Rossdonaldson1: /* Background */

2026-02-04T21:46:55Z

Background

← Older revision		Revision as of 21:46, 4 February 2026
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	==Background==		==Background==
			[[File:Schematic diagram of the human eye en.png\|thumb\|Eye anatomy.]]
	*Ocular foreign bodies are a high-risk chief complaint because of short and long-term threats to vision loss. The main goal is to determine superficial vs. intraocular foreign bodies.		*Ocular foreign bodies are a high-risk chief complaint because of short and long-term threats to vision loss. The main goal is to determine superficial vs. intraocular foreign bodies.
	*Always consider possibility of multiple foreign bodies		*Always consider possibility of multiple foreign bodies

Rossdonaldson1 at 12:02, 23 April 2022

2022-04-23T12:02:37Z

← Older revision		Revision as of 12:02, 23 April 2022
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	**Moderate reaction - aluminum, mercury, nickel, zinc		**Moderate reaction - aluminum, mercury, nickel, zinc
	**Inert - glass, lead, plastic, porcelain		**Inert - glass, lead, plastic, porcelain

			{{FB types}}

	==Clinical Features==		==Clinical Features==

Elcatracho: /* Superficial ocular foreign body with no signs of open globe injury */

2021-02-09T18:01:59Z

Superficial ocular foreign body with no signs of open globe injury

← Older revision		Revision as of 18:01, 9 February 2021
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	*Rust ring		*Rust ring
	**Metallic foreign bodies can create rust rings that are toxic to corneal tissue		**Metallic foreign bodies can create rust rings that are toxic to corneal tissue
	**~~May~~ be removed with a 30- to 25-gauge needle as below		**Foreign body be removed with a 30- to 25-gauge needle as below
	**Rust rings overlying the visual axis, however, should be managed by an ophthalmologist due to the risk of scarring in the visual field.		**Rust rings overlying the visual axis, however, should be managed by an ophthalmologist due to the risk of scarring in the visual field.
	**Rust also often reaccumulates by the next day requiring additional burring. It is therefore not necessary to remove a rust ring in the emergency department if the patient can be seen by an ophthalmologist the next day. Additionally, once the foreign body is removed, the rust ring area softens overnight and can be more easily removed in the office the next day.		**Rust also often reaccumulates by the next day requiring additional burring. It is therefore not necessary to remove a rust ring in the emergency department if the patient can be seen by an ophthalmologist the next day. Additionally, once the foreign body is removed, the rust ring area softens overnight and can be more easily removed in the office the next day.

ClaireLewis: /* Management */

2019-10-20T15:08:34Z

Management

← Older revision		Revision as of 15:08, 20 October 2019
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	**Repeat Seidel test to ensure removal did not perforate cornea		**Repeat Seidel test to ensure removal did not perforate cornea
	**Irrigate eye profusely post-removal		**Irrigate eye profusely post-removal
	**Consider [[~~cycloplegics~~]] (e.g. [[cyclopentolate]] or [[homatropine]]) for significant photophobia		**Consider [[cycloplegic]]s (e.g. [[cyclopentolate]] or [[homatropine]]) for significant photophobia
	**Consider topical antibiotics for corneal involvement		**Consider topical antibiotics for corneal involvement
	***Target [[gram-positive]] + [[pseudomonas]] (contact wearers)		***Target [[gram-positive]] + [[pseudomonas]] (contact wearers)

ClaireLewis at 17:32, 24 September 2019

2019-09-24T17:32:17Z

← Older revision		Revision as of 17:32, 24 September 2019
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	===Superficial (embedded in conjunctiva or cornea)===		===Superficial (embedded in conjunctiva or cornea)===
	*Eye pain		*[[Eye pain]]
	*Foreign body sensation		*Foreign body sensation
	*Tearing		*Tearing
	*~~Blurry Vision~~		*[[Blurred vision]]
	*Relief of pain with topical anesthesia		*Relief of pain with topical anesthesia

	===Intraocular===		===Intraocular===
	*As above, although may additionally be asymptomatic initially and present after complications arise (e.g. corneal ulcer)		*As above, although may additionally be asymptomatic initially and present after complications arise (e.g. corneal ulcer)
	*+~~Sidel~~'s sign: streaming of fluorescein out of eye		*+Seidel's sign: streaming of fluorescein out of eye

	==Differential Diagnosis==		==Differential Diagnosis==
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	**Eye exam		**Eye exam
	***[[Slit lamp exam]] with fluorescein		***[[Slit lamp exam]] with fluorescein
	***Intraocular pressure		***[[Intraocular pressure]]
	***Extensive ocular exam with lid eversion or sweep to check for subtarsal foreign bodies		***Extensive ocular exam with lid eversion or sweep to check for subtarsal foreign bodies
	**CT orbit		**CT orbit
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	**Eye exam only		**Eye exam only
	***[[Slit lamp exam]] with fluorescein		***[[Slit lamp exam]] with fluorescein
	***Intraocular pressure		***[[Intraocular pressure]]
	***Extensive ocular exam with lid eversion or sweep to check for subtarsal foreign bodies		***Extensive ocular exam with lid eversion or sweep to check for subtarsal foreign bodies

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	==Management==		==Management==
	*[[Tetanus]] booster as needed		*[[Tetanus]] booster as needed
	*Pain control with topical [[NSAIDs]] (e.g. [[diclofenac]] or [[ketorolac]]) or oral [[opioids]]		*[[Analgesia\|Pain control]] with topical [[NSAIDs]] (e.g. [[diclofenac]] or [[ketorolac]]) or oral [[opioids]]

	===Superficial ocular foreign body with no signs of open globe injury===		===Superficial ocular foreign body with no signs of open globe injury===
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	*Prophylactic empiric [[antibiotics]]		*Prophylactic empiric [[antibiotics]]
	*Placement of rigid eye shield		*Placement of rigid eye shield
	*Analgesia (oral [[NSAIDS]] or [[opioids]]) and [[antiemetics]] as necessary		*[[Analgesia]] (oral [[NSAIDS]] or [[opioids]]) and [[antiemetics]] as necessary

	==Disposition==		==Disposition==

PoppyCat: /* Superficial ocular foreign body with no signs of open globe injury */

2019-01-21T01:47:35Z

Superficial ocular foreign body with no signs of open globe injury

← Older revision		Revision as of 01:47, 21 January 2019
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	***Cotton-tipped swab soaked in saline		***Cotton-tipped swab soaked in saline
	*Rust ring		*Rust ring
	**~~Not a true emergency as many will wash out spontaneously~~		**Metallic foreign bodies can create rust rings that are toxic to corneal tissue
	**May be removed with a 30- to 25-gauge needle as below		**May be removed with a 30- to 25-gauge needle as below
			**Rust rings overlying the visual axis, however, should be managed by an ophthalmologist due to the risk of scarring in the visual field.
			**Rust also often reaccumulates by the next day requiring additional burring. It is therefore not necessary to remove a rust ring in the emergency department if the patient can be seen by an ophthalmologist the next day. Additionally, once the foreign body is removed, the rust ring area softens overnight and can be more easily removed in the office the next day.
	*[[Corneal foreign body]]		*[[Corneal foreign body]]
	**ED removal after topical anesthetic		**ED removal after topical anesthetic

Mholtz at 01:55, 16 November 2018

2018-11-16T01:55:28Z

← Older revision		Revision as of 01:55, 16 November 2018
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	*Superficial ocular foreign body after removal		*Superficial ocular foreign body after removal
	**Ophtho follow up in 48h for routine cases		**Ophtho follow up in 48h for routine cases
	**Ophtho follow up in 24h for rust ring removal		**Ophtho follow up in 24h for rust ring removal (rust ring will migrate more and more superficially over time making later removal by ophtho easier)
	***Rust ring will migrate more and more superficially over time making removal by ophtho ~~much more likely~~

	===Admission===		===Admission===
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	==See Also==		==See Also==
			*[[Conjunctival abrasion]]
	*[[Corneal abrasion]]		*[[Corneal abrasion]]
			*[[Corneal ulcer]]
	*[[Eye Algorithms (Main)]]		*[[Eye Algorithms (Main)]]
	*[[Corneal ulcer]]
	*[[Conjunctival abrasion]]
	*[[Foreign bodies]]		*[[Foreign bodies]]

	==External Links==		==External Links==


	==References==		==References==

Kxl328: /* Background */

2018-11-03T21:00:15Z

Background

← Older revision		Revision as of 21:00, 3 November 2018
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	*Ocular foreign bodies are a high-risk chief complaint because of short and long-term threats to vision loss. The main goal is to determine superficial vs. intraocular foreign bodies.		*Ocular foreign bodies are a high-risk chief complaint because of short and long-term threats to vision loss. The main goal is to determine superficial vs. intraocular foreign bodies.
	*Always consider possibility of multiple foreign bodies		*Always consider possibility of multiple foreign bodies
			*Common materials based on inflammatory reactions
			**Highest inflammatory response - wood, copper, iron, steel
			**Moderate reaction - aluminum, mercury, nickel, zinc
			**Inert - glass, lead, plastic, porcelain

	==Clinical Features==		==Clinical Features==

Kxl328: /* Outpatient Ophthalmology Follow-up */

2018-10-17T05:04:39Z

Outpatient Ophthalmology Follow-up

← Older revision		Revision as of 05:04, 17 October 2018
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	**Ophtho follow up in 48h for routine cases		**Ophtho follow up in 48h for routine cases
	**Ophtho follow up in 24h for rust ring removal		**Ophtho follow up in 24h for rust ring removal
			***Rust ring will migrate more and more superficially over time making removal by ophtho much more likely

	===Admission===		===Admission===

Rossdonaldson1: /* See Also */

2017-03-30T13:17:41Z

← Older revision		Revision as of 13:17, 30 March 2017
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	==See Also==		==See Also==
	*[[Corneal foreign body]]
	*[[Corneal abrasion]]		*[[Corneal abrasion]]
	*[[Eye Algorithms (Main)]]		*[[Eye Algorithms (Main)]]
	*[[Corneal ~~Ulcer~~]]		*[[Corneal ulcer]]
	*[[Conjunctival ~~Abrasion~~]]		*[[Conjunctival abrasion]]
	*[[Foreign bodies]]		*[[Foreign bodies]]