Foreign bodies in the eye – what to do? Guide

Foreign bodies entering the eye can injure the pain-sensitive cornea or conjunctiva of the eye. In this way, inflammation of the cornea and corneal erosions can be caused.

Since in most cases only small particles enter the eye, you can easily provide first aid yourself. If the foreign body cannot be easily removed and there is no improvement in the foreign body sensation in the eye, you should urgently book an appointment with the ophthalmologist. Especially if it is metal, wood or glass splinters.

In this article, you will learn how to best react to foreign objects in your eye, what dangers they pose and when it is advisable to see a doctor.

Foreign bodies in the eye – first aid:

As a rule, foreign bodies in the eye are flushed out of the eye by the lacrimal fluid alone. If this is not the case, you should provide first aid as soon as possible.

• You can easily remove small, harmless foreign objects (eyelashes or dust grains) from the surface of the eye by rinsing the eye with clean water or tear replacements.                                                                                                                                                                
• If the particle slips under the lower eyelid, you often need a helper to remove it. This gently pulls the lid down to clean the eye using a clean tissue or cotton swab. 
• If the cause is below the upper eyelid, fold it upwards in order to be able to easily detect and remove the foreign body. 
• If sharp-edged foreign bodies strike with force, they can almost penetrate the eyeball, and thus reach the eye socket next to or behind the eyeball. In this case, you must see an ophthalmologist immediately. Try not to touch the eye as much as possible to avoid permanent impairment of vision.
• In case of contact with corrosive chemicals, rinse the eye thoroughly with water and consult an ophthalmologist immediately.

What you can do yourself against foreign bodies in the eye

If foreign bodies get into the eye, it is important to act quickly. Even the eye itself tries to get rid of the intruder through tears and blinking. If this is not successful, you have a good chance of removing the foreign object yourself or with the help of a second person.

In which direction should the foreign body be rubbed in the eye?

Always make sure to proceed cleanly, carefully and towards the root of the nose. This will prevent additional irritation and contamination. Since the eye should not be irritated by the cleaning, it is advisable to dab instead of wiping the eye.

If there is a suspicion that chemicals have gotten into the eye, it is particularly important to rinse thoroughly with plenty of clean water. In addition, you should consult an ophthalmologist as soon as possible, who can examine for possible burns.

Causes and possible diseases

A foreign body sensation in the eye is not always due to an actual foreign body. Often, different external stimuli underlie the perception. These include, for example:

• Draft
• Smoke
• Working on the PC
• poor lighting
• bright sunlight

In addition, various eye diseases are also possible, which cause an unpleasant sensation of irritation and pressure. Among the best known are:

• Conjunctivitis
• Corneal inflammation 
• Barley grain (the barley grain on the eye is an acute purulent inflammation at the edge of the eyelid)
• Hailstones (chronic inflammation of sebaceous glands on the edge of the eyelid)

Foreign bodies in the eye – risks

Since the eye is one of the most sensitive sensory organs of the body, a foreign body in the eye not only brings discomfort, but also various risks.

If the foreign body is only on the surface of the eye, it is usually easy to remove. Possible complaints such as a disturbing feeling of pressure on the eyes or a reddened conjunctiva subside so quickly.

If a sharp-edged splinter causes injury to the eye, serious symptoms may occur. These vary in severity depending on the severity of the injury. If you are struggling with any of the following conditions, you should see an ophthalmologist.

• Pain
• blurred vision
• Photosensitivity of the affected eye
• Swelling of the eyelid
• Inflammation in the eye 
• Decrease or loss of vision

Foreign body sensation – When is a visit to the doctor advisable?

Since only an ophthalmologist can determine whether and to what extent the penetrated foreign body has injured the eye, a visit to the doctor is advisable in any case. In addition, certain foreign objects such as small splinters or limescale in the eye should generally only be removed by a doctor. In this way, control becomes virtually unavoidable.

On the way to the ophthalmologist, you should carefully cover the affected eye to prevent moving the foreign body or otherwise injuring or contaminating the eye.

For example, a sterile pad or at least your own hollow hand is suitable for this. This must be cleaned and then held over the eye. Even after removing the foreign body, signs of a serious eye injury may occur. Such signs are:

• severe or unrelenting pain in the eye
• Visual impairment
• leaking blood or other secretions from the eye
• significant changes in the eye (e.g. haemorrhage, corneal opacity)

It is imperative to respond to these symptoms and visit an ophthalmologist or an eye clinic as soon as possible. Otherwise, you risk permanent impairment of your vision.

Examinations at the doctor – How is the diagnosis made?

First, visual acuity and eye pressure are checked in a preliminary examination. Then the attending physician informs himself after the accident and examines the injured eye externally.

Depending on the severity of the injury, various examinations are then carried out to determine how severely the shells of the eye have been injured.

The ophthalmologist looks at the fundus and examines the eyelid and pupil function. Eye mobility and posture may also be impaired in the event of severe injury and will be checked.

In individual cases, an X-ray examination or an examination by ultrasound and/or CT may be necessary. This allows metal particles to be detected and located. If there is a suspicion of a non-metallic foreign body in the eye, an MR examination can also be ordered.

Treatment by the doctor

The type of treatment by the ophthalmologist depends on the extent of any eye injuries. If the foreign body is superficially located in the cornea, the doctor can carefully dissolve the particle under the so-called slit lamp microscope and, in many cases, remove any remaining impurities with fine instruments.

It may be necessary to fold the eyelid upwards to remove it. He can determine whether and how much her cornea has been injured with the help of special coloured eye drops. If the foreign body is deeper in the eye, surgical intervention is usually required.

Prevent foreign bodies in the eye

Foreign objects can also be avoided. Safety glasses should be worn for certain activities. Such as grinding, milling, welding and working with corrosive liquids, eye injuries can be avoided.

However, it is not only in everyday working life that you should observe the safety regulations. Even in the private sector, it is advisable to protect the eyes during appropriate work. In addition to sporting activity, this also includes gardening, which often leads to corneal injuries.

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