Corneal Foreign Body

A piece of metallic solder material lodged superficially on the cornea. 

  • Frequently occurs during grinding and drilling steel without wearing protective goggles.

Clinical features:

  • Symptoms: foreign body sensation, continuous irritation or ocular pain.
  • Signs:
    • Variety of objects may accidentally be lodged superficially or embedded deep within the cornea
    • Vertical corneal abrasions give clues about upper tarsal embedded foreign bodies
    • Metallic foreign bodies often leave rust rings in the surrounding cornea.

Management:

  • Careful examination of the entire eye to rule out intraocular foreign bodies.
  • CT-scanning or MRI (contraindicated when metallic foreign body is suspected).
  • Superficial foreign bodies may simply be removed at the slit lamp after instillation of a topical anesthetic using a moist cotton-tipped applicator of fine gauge needle.
  • Irrigation is occasionally done to dislodge multiple particles or small fragments.
  • Superior tarsal conjunctiva has to be carefully examined, as it is a common location for a hidden foreign body.
  • Deeply embedded foreign bodies may be removed with forceps.
  • If perforation is suspected, the removal should be done in the OR.
  • Every foreign body should be removed unless removal may cause greater damage than allowing it to stay undisturbed.