Removal of Corneal Foreign Bodies
As the front part of the eye, the cornea is the most exposed to foreign bodies. Should any foreign body become lodged in the cornea, extreme caution must be exercised in order to remove it.
It can be common for foreign bodies such as glass, metal, sand, plastic or wood to be embedded in the corneal surface. These foreign bodies need to be removed expediently by an eye surgeon so as to prevent an eye infection and/or inflammation, as well as vision reducing scar tissue, which can frequently occur. Additionally, with time, the foreign body gets pushed deeper and deeper into the cornea, sometimes penetrating all the way through the entire cornea, becoming dislodged internal within the eye, referred to as an intraocular foreign body (IOFB). Depending on the type and nature of the foreign body, the presence of an IOFB can destroy the eye in not surgically removed in an expedited fashion.
While a common surgical procedure, the utmost care must be taken in order to avoid any further damage. If not removed timely, ocular necrosis or infection may set it.
Before the doctor begins, the patient needs to be administered with eyedrops that will anesthetize the eye. These will allow the treatment to be done without there any additional pain or discomfort for the patient.
Very gently hold the upper eyelid up, and the lower eyelid down, so that the eyelids are essentially immobilized.
Looking through a slit lamp, the doctor can loosen up the foreign body with an extremely sharp needle. One has to be extremely careful so as not to penetrate through the cornea. With the foreign body loosened up, take forceps and very gently remove the foreign body from the eye.
If it’s just one piece, it can be removed in its entirety, if it’s in little pieces remove the pieces one by one.
With the foreign body removed, one can’t just leave the patient because the cornea now has to be repaired. The lodgment of the foreign body will result in a little pothole in the cornea. The doctor must place a therapeutic bandage contact lens right on top of the corneal surface.
This serves two purposes; first the healing of the cornea. The eye sends cells to heal the hole, but this is negated by a blink of the eye. Every time eyelid blinks it's acting like a wiper knocking out those cells. To negate this and allow the eye to heal and blink at the same time, place a very tine contact lens on top of the eye.
The second purpose is to prevent infection. The cornea protects the eye but with it pierced, there is the serious risk of infection. The bandaged lens additionally acts as a barrier to prevent an infection.
Finally, prescribe antibiotic and anti-inflammatory drops to the patient while making additional check-ups so you can see how it’s healing.
If the foreign body does serious damage to the eye, a basic corneal foreign body removal may be insufficient and surgery will be required.