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Complete guide on Removal of Foreign Body from Conjunctiva (Pink Eyes)

  • Posted on- Jan 31, 2018
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Conjunctival Foreign Body in the eye is very common and can be removed with proper technique.

There can be a conjunctival foreign body suspected in the eye if a patient presents with a sensation of something in the eye.

The person suffering from conjunctival foreign body mostly says that their eye feels as if irritating objects like junk, sand or glass is in the eye but that they cannot localize exactly where the sensation is.

The foreign body sensation is often worse upon blinking when the foreign body is located on the conjunctival (inner) surface of the upper lid.

Make sure that a conjunctival foreign body is the cause of the presenting complaint and then perform an appropriate procedure, before starting the removal of the foreign body.

One should ensure that before handling the eye, measure the visual insight in both the affected eye and the fellow eye. A conjunctival foreign body should not cause a significant decrease in visual handling.

Before pressing on the eye, make sure that no penetrating injury of the eye has ever occurred. Such an injury should always be considered when there is a history of power tool use or of hammering metal with metal.

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To minimize the chance of complications, always perform a visual insight determination and a corneal and anterior chamber test. In addition, use an ophthalmoscope to look for the presence of a red reflex.

The following types of equipment stated below are required for removal of a conjunctival foreign body:

  • Topical anesthetic drops
  • A cotton swab moistened with saline
  • A cotton applicator stick or paper clip for eversion of the upper lid
  • A saline irrigation bottle
  • Fluorescein stain
  • A source of illumination, such as a penlight or a minor operating room light
  • A head-mounted magnification device
  • If a slit lamp is available, no additional illumination or magnification is necessary

If a patient complains that something has gotten into the eye, it is usually in the upper or lower conjunctival fornix, mostly the upper one. Don’t be satisfied with finding only 1 foreign body: search for more than 1, and expect to find several more.

First, one should check the eye and try to find any of the foreign bodies on the bulbar conjunctiva, which overlaps the white part of the eye. Make the patient look up, down, left, and right. The eye may be somehow reddened if a conjunctival foreign body is present.

Upper lid eversion is required. Make the patient to look down and then place a cotton stick applicator or paper clip in the upper lid recess.

While the patient continues to look down, hold the upper lid margin lashes with the fingertips of one hand, and pull the lid downwards. Now, the conjunctival surface of the inside of the upper lid is visible.

Remove the cotton applicator stick or paper clip, and use a thumb to press the lid margin of the everted lid against the patient's eyebrow. A foreign body present on the conjunctival surface of the upper lid will usually be easily seen when the lid is everted.

Conjunctival foreign bodies which are located in any of these areas can be removed by gently removing the foreign body with a saline-moistened cotton swab. If a visible foreign body does not observe to the moistened swab, irrigation with saline may be attempted.

If the patient's discomfort before attempted foreign body removal precludes the use of these techniques, 2 drops of local anesthetic may be placed into the eye to allow examination and treatment.

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Once the conjunctival foreign bodies are removed from the eye, one should always examine the patient’s cornea carefully and stain it with fluorescein this should be done even if a foreign body was not found on the conjunctiva.

Foreign bodies present on the upper lid can cause vertical scratches in the cornea as a result of the foreign body having rubbed against the cornea with each blink.

After the removal of the conjunctival foreign body from the eye, two drops of a topical broad-spectrum antibiotic drop should be placed in the affected eye.

The patient should be said to return if the foreign body sensation comes back or if any symptoms of pain, redness, or visual changes occur.

What are the different types of tests needed for the surgery of Removal of Foreign Body from Conjunctiva?

Different types of tests needed for the surgery of Removal of Foreign Body from Conjunctiva:

1.    Plain Radiography

2.    CT scan of the orbits

3.    MRI (if metal foreign body is suspected)

What is the cost of Removal of Foreign Body from Conjunctiva?

The cost of any surgery varies significantly between surgeons, medical facilities, and regions of the country. The fee will also vary depending on whether local or general anesthesia is used.

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