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Cornea & External Diseases

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Trauma

Corneal foreign body: a minute piece of glass is embeeded on the anterior cornea. There is no evidence of penetrating injury.


  • Frequently occurs during grinding and drilling steel without wearing protective goggles.
  • Clinical features:
    • Symptoms: foreign body sensation, continuous irritation or ocular pain.
    • Signs:
      • Variety of objects may accidentally be lodged superficially or embedded deep within the cornea
      • Vertical corneal abrasions give clues about upper tarsal embedded foreign bodies
      • Metallic foreign bodies often leave rust rings in the surrounding cornea.
  • Management:
    • Careful examination of the entire eye to rule out intraocular foreign bodies.
    • CT-scanning or MRI (contraindicated when metallic foreign body is suspected).
    • Superficial foreign bodies may simply be removed at the slit lamp after instillation of a topical anesthetic using a moist cotton-tipped applicator of fine gauge needle.
    • Irrigation is occasionally done to dislodge multiple particles or small fragments.
    • Superior tarsal conjunctiva has to be carefully examined, as it is a common location for a hidden foreign body.
    • Deeply embedded foreign bodies may be removed with forceps.
    • If perforation is suspected, the removal should be done in the OR.
    • Every foreign body should be removed unless removal may cause greater damage than allowing it to stay undisturbed.
  • Medical therapy:
    • Topical antibiotics after foreign body removal.
    • Topical non-steroidal anti inflammatories such as ketorolac 0.5% and a short acting cycloplegic for marked ocular discomfort or inflammation and for relief of symptoms.

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