This morning a patient came into the urgent care complaining that he felt like he got something into his right eye after doing some weed whacking with a string trimmer yesterday afternoon. He tried irrigating his eye at home with his wife’s help but it still feels very irritated so he decided to come in for evaluation. Patient’s often wonder what to do when they get something in their eye and whether they should be seen in the clinic.
When we get something in our eye and it disrupts the surface layer, we call this a corneal abrasion. Even if the piece of dirt, sand or other object has been removed, simply having scratched the surface layer of the eye can be painful for days and even lead to an eye infection. We usually classify this type of injury based on whether the reason for the scratch to the surface layer of the eye is due to trauma, a foreign body such as a piece of dirt or sand, contact lens related or spontaneous.
Symptoms: The outside layer of the eye called the cornea has lots of sensory pain fibers. Patients typically complain of excruciating eye pain and difficulty opening the eye due to feeling like they have something in the eye. Patients are often not comfortable enough to drive, read or work and often cannot sleep. If patients keep trying to wash the object out, it can lead to further damage to the surface of the eye.
Complications: If a piece of metal becomes embedded within the surface layer of the eye, it can rust and can cause a permanent rust ring within the eye than can affect vision. It’s important to make sure any metal is removed as soon as possible. Foreign objects within the eye can also lead to bacterial infections that can cause redness, swelling, drainage and even permanent eye damage if not treated.
Treatment: After a thorough evaluation often with specialized equipment to look at the cornea, visual testing and specialized eye tests, the treatment will depend on what we find, but may include:
1) Remove the foreign body – this may be done using irrigation, or with instrumentation and a slit lamp (if available)
2) Topical antibiotic therapy to prevent or treat infection
3) Pain relief
4) Do not wear contact lenses for 7-10 days until after the abrasion is healed
Home treatment recommendations:
1) If you think there is something embedded in your eye (such as a glass or metal fragment), do not try to remove it. Go directly to your healthcare provider.
2) If you get a chemical burn to your eye, this is a medical emergency and you should be evaluated by your healthcare provider as soon as possible. If you’re at work, you should flush your eye with water at the nearest eyewash station. If you are at home, you can flush your eye by holding your head under the faucet or by pouring water into your eye from a clean container. Continue flushing for 15 to 30 minutes. You should be evaluated by a medical professional.
3) Never rub your eye
4) Wash your hands
3) Look in the mirror and try to find the object in your eye
5) If the object is under the upper eyelid, grasp the lashes of your upper eyelid and pull it down while looking upwards. After your’ve done this and if you see the object is out from under the top eyelid, flush the eye with saline
6) If the object is under the lower eyelid, remove it with a clean wet cotton swab or the corner of a clean cloth while holding the lower lid open.
7) Flush the eye with lukewarm water
This document is for informational purposes only, and should not be considered medical advice for any individual patient. If you have questions please contact your medical provider.
I hope that you have found this information useful. Wishing you the best of health,
Scott Rennie, DO