From the Guidelines
If you have metal shards in your eye, seek immediate medical attention at an emergency room or ophthalmologist. This is because metal shards can cause serious complications including corneal scarring, infection, and rust rings that develop when metal oxidizes in the eye tissue, as highlighted in the 2024 American Heart Association and American Red Cross guidelines for first aid 1.
According to the guidelines, a person who sustains a high-velocity eye injury, such as injuries from grinding or machinery, should seek immediate medical attention 1. Additionally, a person who has persistent foreign-body sensation in the eye should also seek immediate medical attention 1.
While waiting for medical care, gently rinsing your eye with clean water or saline solution if available, but do not apply pressure, is a reasonable step to take 1. It is also important not to rub your eye or attempt to remove the metal yourself as this can cause further damage to the cornea or deeper eye structures 1.
Medical professionals will typically remove the metal fragment using specialized tools under magnification, followed by antibiotic eye drops such as erythromycin or ciprofloxacin to prevent infection 1. They may prescribe pain relief and sometimes a tetanus shot if your immunization is not current.
Some key points to consider when dealing with metal shards in the eye include:
- Seeking immediate medical attention to prevent serious complications
- Not rubbing your eye or attempting to remove the metal yourself
- Gently rinsing your eye with clean water or saline solution if available
- Allowing medical professionals to remove the metal fragment using specialized tools
- Following up with antibiotic eye drops and pain relief as prescribed by a medical professional.
Overall, the priority should be to seek immediate medical attention to ensure proper removal of the metal shards and prevent any potential complications, as emphasized in the 2024 guidelines 1.
From the Research
Metal Shards in the Eye
- Metal shards in the eye can cause serious damage and potentially lead to loss of vision 2
- Intraocular foreign bodies, such as metal shards, can be overlooked by patients and physicians, and may not be immediately apparent 2
- Symptoms of ocular siderosis, such as cataract development, can be a sign of a retained intralenticular metallic foreign body 2
Treatment and Management
- Cataract surgery using phacoemulsification can be an effective treatment for removing metallic foreign bodies from the eye 2
- Antibiotic prophylaxis may be necessary to prevent infection in cases of penetrating eye trauma, with levofloxacin being a suitable option 3
- The choice of antibiotic prophylaxis should be determined on a case-by-case basis, taking into account individual patient factors and available resources 3
Important Considerations
- Patients with metal shards in their eye may not always report a history of eye injury, making it essential to consider the possibility of an intraocular foreign body even if the patient denies it 2
- The use of fluoroquinolones, such as moxifloxacin and levofloxacin, should be carefully considered in special patient populations, such as the elderly and those with liver or kidney disease, due to the potential for rare but clinically important adverse events 4