Corneal Abrasions and Corneal Foreign Bodies

Prior to removing a corneal foreign body, the doctor usually numbs the surface of the eye with an anesthetic drop (such as proparacaine). The doctor also administers an eye drop containing a dye (fluorescein) that glows under special lighting, making surface objects more visible and revealing abrasions. Using a slit lamp Slit-Lamp Examination A person who has eye symptoms should be checked by a doctor. However, some eye disorders cause few or no symptoms in their early stages, so the eyes should be checked regularly (every 1 to 2... read more or other magnifying instrument, the doctor then removes any remaining foreign objects. Often the foreign object can be lifted out with a moist sterile cotton swab or flushed out with sterile water (irrigation). If the person is able to stare without moving the eye, foreign objects that cannot be dislodged easily with a swab can often be removed painlessly with a sterile hypodermic needle or a special instrument.

When iron or steel foreign bodies are removed, they can leave a ring of rust, which may need to be removed with a sterile hypodermic needle or a low-speed rotary sterile burr (a small surgical tool with a tiny, rotating, grinding, and drilling surface).

Sometimes a foreign body is trapped under the upper eyelid. The eyelid must be flipped over (a painless procedure) to remove the foreign body. Doctors may also gently rub a sterile cotton swab over the inside of the eyelid to remove any tiny particles that may not be visible.

Corneal abrasions are treated similarly whether or not a foreign body was removed. Usually, an antibiotic ointment (for example, bacitracin with polymyxin B) is given for a few days to prevent infection. Large abrasions may require additional treatment. The pupil is kept dilated with cycloplegic eye drops (such as cyclopentolate or homatropine) if people are sensitive to light. These drops prevent painful spasm of the muscles that constrict the pupil.

Pain can be treated with oral drugs such as acetaminophen or occasionally with acetaminophen with oxycodone. Some doctors give diclofenac or ketorolac eye drops to help relieve pain, but care must be taken because these drugs could rarely cause complications such as a type of corneal scarring (called corneal melting). Anesthetics that are applied directly to the eye, although they relieve pain effectively, should not be used after evaluation and treatment because they can impair healing.

Eye patches may increase the risk of infection and usually are not used, particularly for abrasions that result from a contact lens or an object that may be contaminated with soil or vegetable matter.