Modern Family Doctor: Dealing with Eye Foreign Body Injuries

Modern Family Doctor: Dealing with Eye Foreign Body Injuries

Overview

Eye foreign body injuries are a common concern, often caused by various materials such as metal, glass, and wood. The nature of the foreign body and its location within the eye can significantly impact the treatment approach. This article provides a comprehensive guide on the types of eye foreign body injuries, their symptoms, and the appropriate medical interventions.

Types of Eye Foreign Body Injuries

1. Eye Surface Foreign Bodies

• Lid Foreign Bodies: Commonly found in explosive injuries, these are often composed of small particles like gunpowder, dust, and sand. Larger particles can be removed with forceps.
• Conjunctival Foreign Bodies: These include dust and coal particles and can cause irritation. Treatment involves using surface麻醉剂 and sterile cotton swabs to remove the foreign body, or by rinsing the conjunctival sac with a saline solution and applying antibiotic eye drops.
• Corneal Foreign Bodies: Typically iron or coal particles, they cause pain, photophobia, lacrimation, and eyelid spasm. Plant material can lead to infection. Surface foreign bodies can be removed with saline-soaked cotton swabs, while deeper ones may require an injection needle. Multiple foreign bodies are often removed in stages, starting with superficial ones.

2. Orbital Foreign Bodies

• Orbital Foreign Bodies: These include metal fragments, pellets from air guns, or wooden or bamboo splinters. They can cause swelling, pain, and may lead to orbital cellulitis or fistula if infected. Immediate surgical removal is recommended based on the injury's severity.

Eye Intraocular Foreign Bodies

Intraocular foreign bodies are serious eye injuries that can significantly affect vision. Diagnosis is based on the patient's history and clinical presentation, with the presence of a wound being a critical indicator.

• Retinal Foreign Bodies: If the anterior segment media is clear, the foreign body can often be seen directly under a slit lamp or ophthalmoscope. Further examination with anterior chamber or three mirror examination may be necessary. Retinal toxicity can be assessed using electroretinography (ERG). Imaging techniques such as X-ray, B-ultrasound, ultrasound biomicroscopy, and CT scans can be used, though MRI is not suitable for magnetic foreign bodies.

Treatment of Eye Intraocular Foreign Bodies

• Early surgical removal is crucial. The method of removal depends on the type of foreign body. For example, anterior chamber and iris foreign bodies can be removed through a corneal incision, magnetic foreign bodies can be removed with an electromagnet, and non-magnetic foreign bodies can be removed with forceps.
• Cataract: If the cataract is dense and the lens is cloudy, it may be necessary to remove the cataract along with the foreign body.
• Posterior Segment Foreign Bodies: Small foreign bodies that are completely encapsulated within the wall of the globe may not need to be removed. For very small iron foreign bodies, repeated ERG checks may be helpful. If the b-wave amplitude decreases, removal is recommended.

Conclusion

Eye foreign body injuries require prompt and appropriate medical attention. The type of foreign body, its location, and the patient's condition will dictate the treatment approach. Early intervention is key to preserving vision and preventing complications. If you suspect a foreign body in your eye, seek medical attention immediately.