MDT Eye ocular foreign body

Question 1

What would you suspect?
Symptoms: Foreign body sensation, tearing, history of trauma.
Signs:
-Conjunctival injection, eyelid edema, mild AC reaction, and SPK. A small infiltrate
may surround a corneal foreign body; it is usually reactive and sterile. Vertically
oriented linear corneal abrasions or SPK may indicate a foreign body under the
upper eyelid.
-Critical: Conjunctival or corneal foreign body with or without a rust ring.

Answer 1

Ocular Foreign Body

Question 2

What is a foreign body superficially or partially embedded on the cornea or conjunctiva

Answer 2

Ocular Foreign Body

Question 3

Differential Diagnosis for ocular foreign body

Answer 3

(1) Full-thickness corneal foreign body
(2) Laceration
(3) Penetrating wound
(4) Intraocular foreign body

Question 4

What would you ask History of the ocular foreign body

Answer 4

size, weight, velocity, force, shape, and composition of the object

Question 5

Labs/Studies/EKG for ocular foreign body

Answer 5

-Fluorescein staining for corneal abrasions after open globe ruled out
-Slit lamp examination
-Dilate the eye and examine the posterior segment for a possible intraocular foreign body.

Question 6

True/false
You can order an MRI for an ocular foreign body to identify if its metallic.

Answer 6

FALSE
Avoid MRI if there is a possible metallic foreign body.

Question 7

True/False
Document visual acuity before any procedure is performed

Answer 7

True

Question 8

What can you use to remove the foreign body

Answer 8

saline irrigation , foreign body spud, cottontipped
applicator soaked in topical anesthetic, fine forceps

Question 9

Topical antibiotics for Ocular foreign body
Non-contact lens wearers
Contact lens wearers

Answer 9

Non-contact lens wearers
a) Erythromycin ointment TID – QID applied to lower lid
b) Ointment may be better than drops because functions as lubricant and may reduce disruption of newly generated epithelium.
2) Contact lens wearers
a) Ciprofloxacin ointment
(1. 0.5inch in lower lid Q 1-2 hours for first 2 days then QID for up to 12 days until re-epithelialization has occurred.

Question 10

True/false
If unable to remove foreign body with irrigation or swab consult MO and optometry or ophthalmology for further recommendations

Answer 10

True

Question 11

True/False
You can remove the foreign body with a needle

Answer 11

FALSE NOOOOOOOOO NEEEEDLEEE

Question 12

Initial Care of the Disease and Follow up
ocular foreign body

Answer 12

Follow up in 24 hours (or sooner if the symptoms worsen) for reevaluation.

Question 13

Ocular foreign body Complications:

Answer 13

(1) Corneal ulcer
(2) Development of infection