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Intraocular Foreign Bodies

By Kathryn Colby, MD, PhD

Foreign bodies inside of the eye are rare. They occur when a foreign object penetrates the eye. A serious infection can develop.

Causes

Explosions can cause intraocular foreign bodies. So can anything with a metal-on-metal mechanism. Explosions and certain tool mechanisms often cause small particles to fly in a person’s face. For example, using high-speed machines (such as drills and saws) or hammering a nail or other metal object with a hammer can produce white-hot particles of metal that resemble sparks. Any of these white-hot particles can enter the unprotected eye and become embedded deep within it.

Foreign bodies that penetrate the inside of the eye can infect the inside of the eye ( endophthalmitis).

Symptoms

During the first hours after injury, symptoms of intraocular foreign bodies may be similar to those of corneal abrasions and foreign bodies. However, people with intraocular foreign bodies may also have a noticeable loss of vision. Fluid may leak from the eye, but if the foreign body is small, the leak may be so small that the person is not aware of it. Also, pain may increase after the first several hours.

Diagnosis

  • A ophthalmologist's evaluation

When a foreign object has penetrated the eye, an ophthalmologist (a medical doctor who specializes in the evaluation and treatment—surgical and nonsurgical—of eye disorders) should examine the person as soon as possible. The eye is examined as for corneal abrasions and foreign bodies by using eye drops that contain a dye that glows under special lighting (fluorescein) and a slit lamp. The dye and slit lamp make visible any small leaks of fluid from the eye and puncture marks.

Any foreign bodies outside of the eyeball are removed. If an intraocular foreign body is suspected after the examination, an imaging study such as computed tomography (CT) is done.

Prevention

People with certain occupations or hobbies, particularly those that use grinders, drills, saws, or hammers, should wear protective eyewear (such as face shields, safety glasses, or goggles) to help prevent intraocular foreign bodies and other eye injuries.

Treatment

  • Antibiotics given by vein

  • Removal of the foreign object, usually with surgery

Antibiotics such as ceftazidime and vancomycin are given by vein.

If necessary, vomiting can be controlled with drugs that treat nausea.

A protective shield (such as a commercially prepared shield or the bottom part of a paper cup) is taped over the eye to avoid unintentional pressure that could further damage the eye.

An ophthalmologist should remove the foreign body as soon as possible. Prompt removal reduces the risk of infection. Usually a surgical procedure is needed to remove the foreign body.

Drugs Mentioned In This Article

  • Generic Name
    Select Brand Names
  • VANCOCIN
  • FORTAZ, TAZICEF

* This is the Consumer Version. *