What to do for a foreign body sensation in the eye?

Management of Foreign Body Sensation in the Eye

For a feeling of something in the eye, allow natural tears to wash out the object or irrigate the eye with tap water or commercial eye wash solution such as Refresh Optive or Systane Ultra. 1

Initial Assessment and Management

When experiencing a foreign body sensation in the eye:

1. First-line approach:

   • Allow natural tears to wash out the object
   • OR irrigate with tap water or commercial eye wash solution 1
   • Commercial eye drops can be instilled as 1-2 drops in the affected eye as needed 2, 3

2. When to seek immediate medical attention:

   • High-velocity eye injuries (grinding, nailing, machinery)
   • Penetrating eye injuries from sharp or metal objects
   • Irregular pupil after trauma
   • Eye bleeding after trauma
   • Loss of vision after trauma
   • Persistent foreign body sensation despite initial management 1

Causes of Foreign Body Sensation

Foreign body sensation can be caused by:

• Loose foreign body (eyelash, dust, sand)
• Foreign body embedded on corneal surface
• Superficial corneal abrasion
• Penetrating eye injury
• Chemical injury
• Ultraviolet radiation exposure
• Eye inflammation or infection 1

Management Algorithm

1. Assess mechanism of injury:

   • Low-energy mechanism (dust, dirt, eyelash): Try self-care first
   • High-energy mechanism (grinding, sharp objects): Seek immediate medical attention

2. For low-energy foreign body sensation:

   • Allow natural tears to wash out the object
   • Irrigate with tap water or commercial eye wash solution
   • Use over-the-counter lubricating eye drops (1-2 drops as needed) 2, 3

3. If discomfort persists after removal:

   • Consider over-the-counter oral acetaminophen or NSAIDs 1

4. Warning signs requiring immediate medical attention:

   • Persistent foreign body sensation despite irrigation
   • Pain that worsens rather than improves
   • Visual changes
   • Eye redness that doesn't resolve
   • Light sensitivity (photophobia) 1, 4

Important Considerations

• Foreign bodies embedded on the cornea often need professional removal 1
• Eye pain can be the first sign of an ophthalmologic emergency 4
• Workplace injuries are a common cause of ocular foreign bodies 1
• Fluorescein staining may be used by healthcare professionals to identify corneal abrasions or foreign bodies 1

Common Pitfalls to Avoid

1. Do not rub the eye - This can cause further damage or push the foreign body deeper
2. Do not attempt to remove embedded foreign bodies - These require professional removal
3. Do not ignore persistent symptoms - Continuing discomfort may indicate a retained foreign body or corneal damage
4. Do not delay seeking care for high-velocity injuries or persistent symptoms - Prompt treatment is essential to prevent complications 1, 4