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    Foreign Body in The Eye: Unit No. 3A

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    danny17ph
    This document discusses the treatment of foreign bodies in the eye by family physicians. It outlines how to properly examine and history a patient presenting with an eye foreign body. Key examination points include using a slit lamp to locate the object and everting the eyelid to check for embedded objects. Most small superficial corneal foreign bodies can be removed in the clinic with topical anesthetic and a bent needle. Referral is necessary if the object has been present for more than 3 days, there is corneal scarring or infection, decreased vision, hyphema, abnormal pupil shape, or possibility of an intraocular foreign body. The document provides guidance on evaluation, removal techniques, and follow-up care including topical antibiotics to prevent infection.

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    Foreign Body in The Eye: Unit No. 3A

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    danny17ph
    24 views2 pages
    This document discusses the treatment of foreign bodies in the eye by family physicians. It outlines how to properly examine and history a patient presenting with an eye foreign body. Key examination points include using a slit lamp to locate the object and everting the eyelid to check for embedded objects. Most small superficial corneal foreign bodies can be removed in the clinic with topical anesthetic and a bent needle. Referral is necessary if the object has been present for more than 3 days, there is corneal scarring or infection, decreased vision, hyphema, abnormal pupil shape, or possibility of an intraocular foreign body. The document provides guidance on evaluation, removal techniques, and follow-up care including topical antibiotics to prevent infection.

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    HOSPITAL STANDARDS PHARMACY

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    Hosp Standards Pharmacy

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    This document discusses the treatment of foreign bodies in the eye by family physicians. It outlines how to properly examine and history a patient presenting with an eye foreign body. Key examination points include using a slit lamp to locate the object and everting the eyelid to check for embedded objects. Most small superficial corneal foreign bodies can be removed in the clinic with topical anesthetic and a bent needle. Referral is necessary if the object has been present for more than 3 days, there is corneal scarring or infection, decreased vision, hyphema, abnormal pupil shape, or possibility of an intraocular foreign body. The document provides guidance on evaluation, removal techniques, and follow-up care including topical antibiotics to prevent infection.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    24 views2 pages

    Foreign Body in The Eye: Unit No. 3A

    Uploaded by

    danny17ph
    This document discusses the treatment of foreign bodies in the eye by family physicians. It outlines how to properly examine and history a patient presenting with an eye foreign body. Key examination points include using a slit lamp to locate the object and everting the eyelid to check for embedded objects. Most small superficial corneal foreign bodies can be removed in the clinic with topical anesthetic and a bent needle. Referral is necessary if the object has been present for more than 3 days, there is corneal scarring or infection, decreased vision, hyphema, abnormal pupil shape, or possibility of an intraocular foreign body. The document provides guidance on evaluation, removal techniques, and follow-up care including topical antibiotics to prevent infection.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    EMERGENCY MEDICINE – WHAT THE FAMILY PHYSICIAN CAN TREAT

    UNIT NO. 3A
    FOREIGN BODY IN THE EYE
    Dr Vivien Lim Sin Yi

    ABSTRACT evert the eyelid to look for any foreign body embedded on the
    One of the most common eye conditions that is seen in the underside of the lid.
    outpatient setting is that of a foreign body in the eye. It is
    important to recognise the red flags and know when to refer to
    an ophthalmologist for further management.
    How To Remove a Corneal Foreign Body
    Seat the patient comfortably. Apply topical anaesthetic to the
    Keywords: Cornea, Foreign Body, Infection, Intraocular eye and, using a 27g needle, bend the tip and approach the eye
    from the side.2 Most corneal foreign bodies can be removed by
    SFP2015; 41(3): 18-19 the general practitioner or emergency doctors. Referral to the
    ophthalmologist is necessary when there is/are:
    INTRODUCTION
    1) More than three days’ history of foreign body in the eye as
    there is high likelihood of secondary infection;
    A foreign body in the eye (metal shard, sand, glass, etc.) is
    2) White opacity on the cornea: suggestive of corneal ulcer;
    something that enters the eye from outside and cause
    3) Decreased visual acuity;
    discomfort and pain to the eye. It can be superficially adherent
    4) Hyphema (blood in the anterior chamber);
    to the cornea or the conjunctiva or a high-velocity injury can
    5) An abnormally shaped pupil;
    cause the foreign body to enter the globe and be embedded in
    6) Possible penetration of the eye with an intraocular foreign
    the lens or on the retina. Foreign bodies in the eye need to be
    body;
    removed in a timely manner to prevent secondary infections
    7) An extremely uncooperative patient;
    from setting in.
    8) Multiple foreign bodies; or
    9) Diffuse subconjunctival haemorrhage.
    History Taking
    It is very important to take a detailed history from the patient
    regarding the circumstances of the injury. If the patient reports REFERENCES
    a high-velocity injury, e.g. during hammering or grinding, a 1. Wong TY. The ophthalmology examinations review. Singapore:
    thorough workup—including imaging studies such as an X-ray World Scientific, 2011.
    of the orbits or a CT scan—is necessary to exclude an 2. Gerstenblith AT, Rabinowitz MP, editors. The Wills eye manual:
    intraocular foreign body. A plain X-ray is only useful for office and emergency room diagnosis and treatment of eye disease,
    radio-opaque foreign bodies and will not detect radiolucent Sixth edition. Philadelphia, PA: Wolters Kluwer Health/Lippincott
    Williams & Wilkins, 2012.
    intraocular foreign bodies such as wood or glass. An MRI scan
    is contraindicated if a metal foreign body is suspected.1

    Ask the patient when the injury occurred and if the patient
    reports an injury that is a few days old, look out especially for
    any secondary infection in the eye. If the offending object is
    rusty or vegetative material, consider giving an anti-tetanus shot
    and start broad-spectrum topical antibiotics such gutt.
    ciprofloxacin or gutt. tobramycin.2

    Patients often complain of eye pain, discomfort and foreign


    body sensation associated with tearing and a red eye.

    Examination
    Slit lamp examination is very important. It is also important to

    VIVIEN LIM SIN YI


    Consultant
    Department of Ophthalmology
    National University Hospital

    T H E S I N G A P O R E F A M I L Y P H Y S I C I A N V O L 4 1(3) J UL -S EP 2 0 1 5 : 18
    FOREIGN BODY IN THE EYE

    LEARNING POINTS
    • History taking is essential in patients who present with a foreign body in the eye.
    • It is important to exclude any intraocular foreign body when the examination shows suspicious
    findings by doing a CT orbit.
    • After removing a corneal foreign body, it is often important to start a broad-spectrum antibiotic
    eyedrop to treat any secondary infection.

    T H E S I N G A P O R E F A M I L Y P H Y S I C I A N V O L 4 1(3) J UL -S EP 2 0 1 5 : 19

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