Indications
Contraindications
Equipment
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• 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.
Risks
Pearls and Tips
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• 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.
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• 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.
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Patient Preparation
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• Apply topical ophthalmic anesthetic solution after foreign body has been visualized or ruled out to decrease pain and facilitate procedure and eye examination.
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