What is the treatment for a foreign body sensation in the eye?

Treatment for Foreign Body Sensation in the Eye

Do not rub the eye—instead, allow natural tears to flush the object or irrigate with tap water/commercial eye wash solution, and seek immediate medical attention if the injury is high-velocity, involves a contact lens, or if symptoms persist despite home treatment. 1

Immediate Home Management for Low-Energy Foreign Bodies

For simple foreign body sensations from dust, eyelashes, or other low-energy mechanisms, follow this approach:

• Never rub the eye, as this embeds the foreign body deeper into the cornea and can cause corneal abrasion 1
• Allow natural tears to wash out the object, or actively irrigate with tap water or commercial eye wash solution 1
• Shield the eye by taping a hard plastic eye shield, paper cup, or plastic cup over it to prevent unintentional touching or rubbing 1
• Take over-the-counter oral acetaminophen or NSAIDs for residual discomfort after the foreign body is removed 1

When to Seek Immediate Medical Attention

Certain presentations require urgent ophthalmologic evaluation rather than home management:

• Contact lens-related foreign body sensation—remove the contact lens immediately, discontinue use, and seek medical attention 1
• High-velocity eye injuries from grinding, nailing, or other projectile mechanisms 1, 2
• Penetrating eye injury from sharp or metal objects 1, 2
• Irregular pupil, eye bleeding, or vision loss after trauma 1
• Persistent foreign body sensation despite appropriate home treatment 1
• Embedded or difficult-to-remove foreign bodies that require ophthalmologist referral 2

Medical Treatment for Corneal Abrasion or Confirmed Foreign Body

When a patient presents to medical care with corneal abrasion or foreign body:

Foreign Body Removal

• Remove visible superficial foreign bodies if possible; refer embedded or difficult cases to ophthalmology 2
• Irrigate the eye with sterile saline or commercial eye wash solution to flush loose material 2
• Topical anesthesia with proparacaine hydrochloride ophthalmic solution facilitates foreign body removal 3

Antibiotic Prophylaxis

• Apply broad-spectrum topical antibiotic prophylaxis (e.g., moxifloxacin drops four times daily) to prevent infection 2

Pain Management

• Use topical NSAIDs such as ketorolac tromethamine ophthalmic solution to decrease pain, photophobia, and foreign body sensation 2
• Prescribe oral analgesics (acetaminophen or NSAIDs) for additional pain relief 2
• Consider cycloplegic agents (e.g., cyclopentolate) to decrease pain from ciliary spasm and anterior segment inflammation 2

What NOT to Do

• Avoid eye patching for corneal abrasions, as recommended by the American Academy of Ophthalmology 2
• Do not prescribe topical corticosteroids in the acute setting, as they can lead to corneal melting and perforation, particularly when corneal anesthesia is present 4

Critical Pitfalls to Avoid

• Self-treatment with topical corticosteroids can cause corneal melting and perforation, especially with delayed foreign body extraction 4
• Corneal anesthesia is an important risk factor that enhances corneal melting—test corneal sensitivity in patients with corneal foreign bodies 4
• Translucent foreign bodies can be missed on initial examination and may erupt months later, requiring high index of suspicion and thorough examination 5
• Ignoring persistent symptoms beyond 24-48 hours warrants medical evaluation, as retained foreign bodies can remain asymptomatic for extended periods before causing complications 5