• 
  

  • Suspected foreign body or corneal abrasion.

  
  

  • History of eye trauma or irritability in a nonverbal patient.

  
  

  • Abnormal sensation or eye pain, foreign body sensation, photophobia.

Absolute

• 
  

  • Penetrating trauma and globe rupture.

• 
  

  • Examination gloves.

  
  

  • Sterile isotonic irrigation solution (0.9% saline or lactated Ringer’s). Tap water at room temperature is an acceptable alternative to prevent treatment delay.

  
  

  • Topical ophthalmic anesthetic solution (proparacaine 0.5% or tetracaine 0.5%).

  
  

  • Cotton-tipped swab.

  
  

  • Eyelid retractor.

• 
  

  • Pain or discomfort.

  
  

  • Eyelid laceration.

  
  

  • Contusion of the lid or globe.

  
  

  • Corneal abrasion.

• 
  

  • Suspect an embedded eyelid foreign body when no object can be visualized and symptoms are persistent.

  
  

  • If possible, do not apply a topical ophthalmic anesthetic until a foreign body is visualized or you are confident that none is present.

  
  
  
  
  • 
    

    • Patients can help localize a foreign body but sensation will be eliminated by the topical anesthetic.

    
    

    • Patient’s inability to feel increases the potential for abrasions since there is no further pain or apprehension with blinking, eye movement, or rubbing.

  
  

  • A smooth, uncoated metal clip can be bent to into an appropriate shape to be used as a retractor after sterilization with alcohol.

  
  

  • Copious irrigation and mechanical removal of a foreign body is necessary to prevent corneal abrasions, infections, ulcerations, perforations, and metallic rust rings.

• 
  

  • Apply topical ophthalmic anesthetic solution after foreign body has been visualized or ruled out to decrease pain and facilitate procedure and eye examination.