Foreign bodies that penetrate the eyeball are rare but can lead to a serious infection and complications including a risk of developing blindness.
(See also Overview of Eye Injuries.)
Causes of Intraocular Foreign Bodies
Explosions and any tool with a metal-on-metal mechanism can cause intraocular foreign bodies by causing small particles to fly in a person’s face. For example, using high-speed machines (such as drills and saws) or hammering a nail or other metal object with a hammer can produce white-hot particles of metal that resemble sparks. Any of these white-hot particles can enter the unprotected eye and become embedded deep within it.
Foreign bodies that penetrate the inside of the eye can damage the structures within the eyeball and lead to an infection inside of the eye (endophthalmitis).
Symptoms of Intraocular Foreign Bodies
During the first hours after injury, symptoms of intraocular foreign bodies may be similar to those of corneal abrasions and foreign bodies. However, people with intraocular foreign bodies may also have a noticeable loss of vision. Fluid may leak from the eye, but if the foreign body is small, the leak may be so small that the person is not aware of it. Also, pain and vomiting may increase after the first several hours, usually because pressure increases inside the eye.
Diagnosis of Intraocular Foreign Bodies
A ophthalmologist's evaluation
Computed tomography (CT)
slit lamp. The dye and slit lamp make visible any small leaks of fluid from the eye and puncture marks.
Any foreign bodies outside of the eyeball are removed. If an intraocular foreign body is suspected after the examination, a CT is done.
Prevention of Intraocular Foreign Bodies
People involved in activities or work using grinders, drills, saws, or hammers, should wear protective eyewear (such as face shields, safety glasses, or goggles) to help prevent intraocular foreign bodies and other eye injuries.
Treatment of Intraocular Foreign Bodies
Antibiotics
Removal of the foreign object, usually with surgery
tetanus vaccine is given as soon as possible.
If necessary, pain and vomiting can be controlled with drugs.
As soon as possible, a protective shield (such as a commercially prepared shield or the bottom part of a paper cup) is taped over the eye to avoid unintentional pressure that could further damage the eye.
An ophthalmologist should remove the foreign body as soon as possible. Prompt removal reduces the risk of infection. Usually a surgical procedure is needed to remove the foreign body.
