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Corneal Foreign Body, Emergency Medicine

Ian C. May and Carl G. Skinner Reviewed 06/2017
 


Basics

Description

  • Foreign material on or in the corneal epithelium

  • Corneal epithelium disrupted:

    • Abrasion if only epithelium disrupted

    • Scar if deeper layers of cornea involved

Etiology

  • Foreign material cau...

Diagnosis

Signs and Symptoms

  • Foreign body (FB) sensation

  • Eye pain

  • Conjunctiva and sclera injection

  • Tearing

  • Blurred or decreased vision

  • Photophobia

  • Visible FB or rust ring

  • Iritis

History

Common complaint: Someth...

Treatment

Pre-Hospital

Place a Fox shield and position the patient upright. 

Initial Stabilization/Therapy

Apply topical anesthetic to stop eye discomfort and assist in exam. 

Ed Treatment/Procedures

  • Deep ...

Follow-Up

Disposition

Admission Criteria

Globe penetration 

Discharge Criteria

All corneal FBs 

Issues for Referral

  • Consult ophthalmologist for:

    • Vegetative material removal owing to risk of ulceration

    • Any evi...

Pearls and Pitfalls

  • Consider intraocular FB, especially with history of high-projectile objects or industrial tools.

  • Clinical evidence does not support eye patching for pain or healing.

  • After removal, m...

Additional Reading

  • Ramakrishnan  T, Constantinou  M, Jhanji  V, et al. Corneal metallic foreign body injuries due to suboptimal ocular protection. Arch Environ Occup Health.  2012;67(1):48–50.

  • Red...

Codes

ICD9

930.0 Corneal foreign body 

ICD10

  • T15.00XA Foreign body in cornea, unspecified eye, initial encounter

  • T15.01XA Foreign body in cornea, right eye, initial encounter

  • T15.02XA Foreign body in corne...

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