Treatment for Foreign Object in the Eye
Do not rub the eye—allow natural tears to wash out loose foreign bodies or irrigate with tap water/sterile saline, and seek immediate medical attention for high-velocity injuries, embedded objects, or any signs of penetrating trauma. 1
Immediate Home Management for Low-Energy Foreign Bodies
For superficial foreign bodies like dust or eyelashes, the initial approach prioritizes preventing further damage:
- Never rub the eye, as this can embed the foreign body deeper into the cornea or cause corneal abrasion 1
- Allow natural tears to flush out the object, or actively irrigate with tap water, sterile saline, or commercial eye wash solution 1, 2
- Tape a hard plastic eye shield, paper cup, or plastic cup over the eye to prevent unintentional touching or rubbing 1
- Take over-the-counter acetaminophen or NSAIDs for residual discomfort after the foreign body is removed 1
When to Seek Immediate Medical Attention
Certain scenarios require urgent ophthalmologic evaluation and should not be managed at home:
- High-velocity eye injuries from grinding, nailing, or other mechanical work 1, 2
- Penetrating eye injury from sharp or metal objects, or suspicion of intraocular foreign body 1, 2
- Contact lens-related foreign body sensation—remove the contact lens immediately and discontinue use 1
- Irregular pupil, eye bleeding (hyphema), or vision loss after trauma 1
- Persistent foreign body sensation despite home treatment 1
Medical Treatment for Corneal Abrasion or Embedded Foreign Bodies
When a patient presents to medical care with a corneal foreign body or resulting abrasion, the American Academy of Ophthalmology recommends the following approach:
Foreign Body Removal
- Remove any visible foreign body if superficial and accessible 2
- If the foreign body is embedded or difficult to remove, refer immediately to an ophthalmologist 2
- Topical anesthesia with proparacaine hydrochloride ophthalmic solution facilitates examination and foreign body removal 3
- Irrigate the eye with sterile saline or commercial eye wash solution to flush out any loose foreign material 2
Antibiotic Prophylaxis
- Apply a broad-spectrum topical antibiotic to prevent infection, such as moxifloxacin drops four times daily 2
Pain Management
- Topical NSAIDs such as ketorolac tromethamine ophthalmic solution significantly decrease pain, photophobia, and foreign body sensation 2
- Oral analgesics (acetaminophen or NSAIDs) provide additional systemic pain relief 2
- Cycloplegic agents like cyclopentolate 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
Common Pitfalls and Caveats
Occult intraocular foreign bodies can present with minimal initial symptoms, particularly with inert materials like fiberglass or glass, making diagnosis difficult 4. Even small metallic foreign bodies can remain undetected and cause delayed complications 5.
Chemical injuries and ultraviolet radiation exposure can mimic foreign body sensation without an actual foreign body present 1. These require different management approaches including prolonged irrigation for chemical burns until pH normalizes 6.
Foreign body-associated infections are a major complication, particularly with retained foreign material, emphasizing the importance of complete removal and antibiotic prophylaxis 7.