From the Guidelines
If you've tried OTC eye drops and water but still have a foreign body in your left eye, seek medical attention promptly. According to the 2024 American Heart Association and American Red Cross guidelines for first aid 1, a person with a foreign-body sensation in the eye should not rub their eye and it is reasonable for a person with a foreign body in the eye from a low-energy mechanism to attempt to remove the foreign body by allowing natural tears to wash out the object or by irrigating the eye with tap water or a commercial eye wash solution. However, since you have already tried these methods and were unsuccessful, it is essential to seek medical attention.
While waiting for medical care, blink gently to see if natural tears can flush out the object, but avoid putting additional eye drops or medications in your eye. The guidelines also recommend taping a hard plastic eye shield, paper cup, or plastic cup over the eye to help prevent unintentional touching of the eye 1. If the object is causing severe pain, sensitivity to light, decreased vision, or if you suspect it's metal or a chemical substance, consider it an emergency. Medical professionals have specialized equipment like slit lamps to safely locate and remove foreign bodies, and can assess for corneal damage. They may use numbing eye drops before removal and might prescribe antibiotic drops afterward to prevent infection.
Key considerations for seeking medical attention include:
- Persistent foreign-body sensation in the eye 1
- High-velocity eye injury or penetrating eye injury from a sharp or metal object 1
- Irregular pupil after trauma, eye bleeding after trauma, or loss of vision after trauma 1 Foreign bodies left in the eye can cause serious complications including infection, corneal ulcers, or even vision loss, which is why professional removal is essential when home methods fail.
From the Research
Foreign Body in the Eye
- The patient has a foreign body in her left eye, which she has been unable to remove despite trying over-the-counter (OTC) eye drops and flushing with water 2, 3.
- The composition and location of the foreign body, as well as the presence of secondary infection, are crucial factors in determining the management and prognosis of the injury 2.
- Organic foreign bodies can elicit an inflammatory reaction and lead to serious complications, whereas metallic objects and glass are generally well-tolerated 2.
Examination and Treatment
- A thorough ocular examination, including tests for visual acuity and ocular movements, is essential in evaluating the patient's condition 4.
- The use of an eye shield may be necessary to protect the injured eye and preserve the patient's vision 4.
- In cases of intraocular foreign body, prompt recognition and appropriate treatment are critical to prevent further damage and improve outcomes 5, 6.
- The removal of the foreign body may be delayed if there are no signs of infection or evidence of retinal detachment, without increasing the risk of endophthalmitis or negatively impacting visual outcomes 5.
Antibiotic Therapy
- Systemic and topical antibiotics may be administered to prevent endophthalmitis, and intravitreal antibiotic therapy may be necessary in some cases 6.
- The choice of antibiotics should cover common pathogens, including Bacillus spp., and should be guided by culture results and antibiotic sensitivities 6.
- Early recognition and enthusiastic antibiotic therapy at the time of foreign body removal are essential in preventing IOFB-associated endophthalmitis 6.