Foreign matter in the eye

Carola Felchner is a freelance writer in the medical department and a certified training and nutrition advisor. She worked for various specialist magazines and online portals before becoming a freelance journalist in 2015. Before starting her internship, she studied translation and interpreting in Kempten and Munich.

More about the experts All content is checked by medical journalists.

Foreign objects in the eye can injure all layers of the eye and lead to inflammation of the inside of the eye. Correct first aid is therefore important. Find out here what you can do yourself with a foreign body in the eye, when a doctor should take over and what options they have to remove the foreign body.

Brief overview

• What to do if there is a foreign object in the eye? Wipe superficial foreign bodies out of your eyes with a clean cloth, rinse out chemicals with plenty of water, leave the treatment to the doctor for deep-seated foreign bodies or severe pain.
• Foreign bodies in the eye - risks: e.g. bleeding into the eye, swelling of the eyelids, inflammation and infections, blurred vision or deterioration in vision
• When to the doctor In principle, a doctor should always look at the foreign body in the eye.

Caution!

• If there is a solid foreign body in the eye (e.g. grain of sand), you should not rub it! That drives him further into the eye, and he may injure the cornea.
• Before tampering with your eyes, you should clean your hands thoroughly and, if possible, disinfect them. This will prevent you from bringing in germs that can inflame the eye.
• If an injury to the conjunctiva or cornea is not treated medically, this can lead to loss of vision!

Foreign bodies in the eye: what to do?

It happens quickly: after a visit to the beach or in the sandpit, the youngsters have sand in their eyes, a mosquito flies into it while cycling or scratches a loose eyelash in the eye: what to do if something like this happens?

First, the eye itself tries to get rid of the foreign body by tearing and blinking more often. In some cases you can actively support the whole thing.

Correctly remove foreign bodies in the eye (instructions):

• Small and rather harmless foreign objects in the eye (e.g. dust particles, eyelashes or grain of sand in the eye) can be tried to wipe out of the eye with a clean cloth from the lower eyelid to the nose.
• If there are chemicals in the eye (e.g. splashes of a cleaning agent), you have to rinse the eye thoroughly with plenty of clean water. To do this, the patient lies flat on his back and tilts his head on the side so that the affected eye is below (near the floor). Then pour water from a height of about ten centimeters into the inner corner of the eye of the affected eye or let the water flow from the bridge of the nose into the eye and on to the floor.

If caustic lime has got into your eyes, you must never rinse it! That would make the burn worse.

Sometimes, to be on the safe side, you should leave it to the doctor to remove the foreign object in the eye. You can find out when this is the case below in the section “When to see a doctor?”.

Foreign bodies in the eye: risks

The eye or the cornea with many nerve fibers running through it is very sensitive. A foreign body in the eye is correspondingly uncomfortable.

A superficial foreign body (e.g. a grain of sand or a small fly in the eye) can usually be removed easily - either by the body itself (through tears and blinking) or with external help (see above). Complaints such as the uncomfortable feeling of foreign bodies in the eye and reddened conjunctiva then quickly subside.

If a foreign object (such as broken glass, metal particles) has caused an eye injury (e.g. by damaging the cornea in the eye or penetrating the eyeball), the matter is more serious. The symptoms and consequences depend on how severe the injury to the eye is. The following are possible:

• pains
• blurred vision
• Sensitivity to light in the affected eye
• Swelling of the eyelid
• Inflammation in the eye (e.g. if the foreign body that has entered is dirty)
• Decrease or loss of vision

Foreign bodies in the eye: when to see a doctor?

Basically, it is best to always see an ophthalmologist if there is a foreign object in the eye. Because only he can determine whether and how severely the foreign body has injured the eye.

In addition, you have to leave the removal of certain foreign bodies in the eye to the doctor anyway. This applies to:

• Lime in the eye
• stuck foreign body in the eye (e.g. glass or metal splinters, plant thorns)

In such cases, you should carefully cover the affected eye, for example with a sterile pad or at least with the cupped hand that the patient holds over the eye. Then visit an ophthalmologist as soon as possible.

In general, a visit to the doctor is also strongly advised if there are signs of serious eye injury (possibly only after the foreign body has been removed). Such signs are:

• severe or persistent pain in the eye
• Leakage of blood or other secretions from the eye
• noticeable changes in the eye (e.g. bleeding, corneal opacity)

Foreign bodies in the eye: check with a doctor

First, the doctor will ask the patient or accompanying persons (first aiders, parents, etc.) how the foreign body got into the eye, what it is and what symptoms there are.

Then the ophthalmologist will examine the eye more closely. If there is a foreign body in the eye, it is often difficult to keep the affected eye open. Then it often helps if the doctor drips in an analgesic.

The exact procedure of the examination depends on the type of foreign body in the eye and the degree of injury. The ophthalmologist will examine the cornea for injuries (corneal erosion) and foreign body residues. He can also check the mobility and position of the eye, as well as visual acuity and field of vision. Often he also tests the eyelid and pupil function and measures the intraocular pressure.

If necessary, the doctor will also examine the eye using ultrasound. This may be necessary if there is bleeding in the eye, for example. If the foreign body could have penetrated deeper into the eye and caused more serious damage, this can be checked with computed tomography (CT) or magnetic resonance imaging (MRI).

Foreign bodies in the eye: treatment by the doctor

If necessary, the doctor will remove the foreign body or foreign body residues from the eye. Further treatment depends on the extent of any eye injuries.

The doctor can carefully pull out superficial foreign bodies in the cornea under the so-called slit lamp microscope (enlarges the eye). If necessary, he will flip up the eyelid to remove it. With the help of eye drops that contain the dye fluroscein, he can determine whether and how severely the cornea has been injured. This makes damage in the cornea more visible.

If a foreign body has penetrated deeper into the eye, surgical intervention is usually necessary. Sometimes a local anesthetic is enough. In more severe cases, the operation is performed under general anesthesia.

An injured eye lens may have to be replaced with an artificial lens. If the foreign body in the eye has injured the vitreous humor (area between the lens and retina), the ophthalmologist may have to remove parts of the vitreous humor (vitrectomy). Laser treatment may be required if the retina is damaged.

Follow-up treatment for a foreign body in the eye

To prevent or treat inflammation of the eye, the ophthalmologist may prescribe anti-inflammatory medication (such as eye ointment or eye drops). Pain-relieving tablets or ointments help against (severe) pain.

In order to check the healing progress, the doctor will ask the patient to come back to the practice a few days later for a check-up.

Prevent foreign bodies in the eye

You should wear protective goggles for (professional) activities in which a foreign body can easily get into your eyes. This is advisable or sometimes even mandatory when welding, milling and grinding as well as handling chemicals.

You can also “catch” a foreign body in the eye while gardening, for example when moving a plant with thorns or sharp leaves or cutting the hedge. As a precaution, you should also wear protective goggles or at least sunglasses during such activities.

Even when doing sports (such as cycling, skiing), sunglasses or the recommended protective goggles can protect you from a foreign body in the eye.

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