Corneal Foreign Body

Who's At Risk?

A corneal foreign body most often occurs in people not wearing eye protection while doing activities such as grinding or drilling metal, cutting or scraping wood, working in the garden, or being in high wind conditions or dusty or debris-laden areas. A corneal foreign body can even result simply from walking down the street or riding in a car with the top or window down.

Signs & Symptoms

Sometimes the foreign object can easily be seen embedded in the cornea, but not always. A person with a corneal foreign body will feel something in their eye that will not wash out. They may also have the following in the affected eye:

• Sharp pain
• Burning
• A scratchy feeling
• Excessive tearing
• Blurred vision or vision loss
• Redness
• Blood in the white of the eye
• Sensitivity to light
• Difficulty opening the eye

Self-Care Guidelines

Often, simply rinsing the eye will eliminate the corneal foreign body. Another measure is to gently pull the upper eyelid over the lower eyelid and release it gently. This maneuver can sometimes dislodge the foreign body so that it will wash out.

Self-care for a corneal foreign body includes:

• Never rubbing the involved eye at any time.
• Using artificial tears to bathe the eye.
• Using clean water to gently rinse the eye.
• Using sunglasses to reduce light sensitivity.
• Keeping the eye shut after gentle rinsing.
• Gently removing a contact lens, if present, and leaving it out until the eye is healed.

Taking precautions such as wearing protective eyewear will significantly reduce your risk of corneal foreign body.

Treatments

If there is a foreign body in the cornea, the medical professional will first remove the corneal foreign body. If the foreign body is deeply embedded in the cornea or there is evidence of a far more serious injury (such as penetration or perforation of the eye), you will need to see an eye care professional such as an ophthalmologist.

Following removal, the medical professional may prescribe antibiotic drops during the day and antibiotic ointment at night for a few days to prevent infection.

Be sure to go to all follow-up appointments to check for proper healing and to ensure there is no resultant eye infection.

Visit Urgency

All children with a suspected corneal foreign body need medical evaluation. Adults should seek medical attention if self-care measures have not helped or if:

• The suspected foreign body is metal, plant, or wood, especially if it came in contact with the eye with significant velocity. High-velocity foreign bodies can cause very serious damage to the eye, including the possibility of permanent blindness.
• You or someone else can see the object still embedded in the cornea.
• There is persistent pain that is increasing.
• There is progressive worsening of vision or initial significant loss of vision.
• There is any bleeding, either on the surface of the eye or around the eye.
• There is mucus, pus, or bloody discharge from the eye.
• Symptoms persist beyond 24 hours despite having already removed the foreign body.

Trusted Links

• MedlinePlus: Corneal Disorders
• MedlinePlus: Eye Injuries
• MedlinePlus: Foreign Bodies
• Clinical Information and Differential Diagnosis of Corneal Foreign Body

References

Duncan JL, Parikh NB, Seitzman GD. Ocular trauma. In: Papadakis M, McPhee S, Rabow M, McQuaid K, eds. Current Medical Diagnosis & Treatment 2023. McGraw Hill; 2023.

Hayden, Jr J, Chumley HS. Corneal foreign body and corneal abrasion. In: Usatine RP, Smith MA, Mayeaux EJ, Chumley HS, eds. The Color Atlas and Synopsis of Family Medicine. 3rd ed. New York, NY: McGraw-Hill Education; 2019.

Mendelsohn A, Pokeza N. Removal of corneal foreign bodies. American Academy of Ophthalmology. https://eyewiki.org/Removal_of_Corneal_Foreign_Bodies. 2023 Sept 10.