When something gets in your eye

Anything like grit, dust or paint that gets into the eye is called a foreign body. There are two types of foreign bodies:

• ‘Superficial foreign bodies’ – these stick to the front of the eye or get trapped under one of the eyelids, but do not enter the eye
• ‘Penetrating foreign bodies’ – these penetrate the outer layer of the eye (cornea or sclera) and enter the eye – these objects are usually travelling at high speed and are commonly made of metal.

Foreign body first aid

If you get a superficial foreign body in your eye, gently rinse the eye with warm water. If you are on your own, an ‘eye bath’ using a clean measuring cup or something similar can make this easier.

Otherwise get someone to help rinse the eye while you are lying down.

Do not try to remove a foreign body with cotton buds, matchsticks or any other type of solid object. If you cannot remove the foreign body with the eyebath, go to your GP or local A&E unit.

You should also contact your doctor if you have had a foreign body in your eye and it continues to irritate you.

If you think something has gone into your eye while you have been grinding or hammering, even if you have little in the way of pain or loss of vision, it is essential that you consult a doctor immediately to report your injury as this could be serious.

How does the doctor make a diagnosis?

Superficial foreign bodies

The doctor will examine the eye using a fluorescein stain, which helps to detect any foreign material on the surface of the eye.

They will also turn the eyelid outwards to examine the underside of the lid and remove any foreign material from that surface.

The doctor can remove the material with a cotton bud, although occasionally they may need a small needle to lift any embedded particles from the eye. The doctor will apply some local anaesthetic drops to your eye before using one of these needles so that it does not hurt.

Top tips for avoiding eye injuries

It is essential to wear protective glasses or goggles to prevent foreign bodies entering your eyes when carrying out work or DIY tasks like:

• Welding
• Using a grinder
• Using a sander
• Using a Strimmer
• Doing DIY.

If you have got something in your eye during one of these activities, a full eye examination will assess any damage you may have done. A serious injury can reduce your vision. The examination may show that the pupil is distorted and that there is blood inside the eye.

You may need to have your eye x-rayed or scanned if the doctor suspects there is foreign material inside the eye.

What happens if the foreign body is not removed from my eye?

If something superficial is lodged in your eye, this will tend to cause persistent irritation and may lead to conjunctivitis. Sometimes the foreign material becomes buried and stops causing problems, although there may be some scarring.

The damage caused by a penetrating foreign body in your eye depends on:

• What the foreign body is made from
• How much damage it causes as it passes into the eye.

Metal foreign bodies that have iron in them can cause a condition called ‘siderosis’, which gradually leads to poor vision over the following months and years.

Some other metals and vegetable materials may cause rapid destruction of the eye or infection inside the eye.

A small foreign body can enter the eye and cause no apparent damage, but it may lead to bleeding within the eye, early cataract formation or damage to the retina. Surgery may be required to correct this damage.

How is a penetrating foreign body removed?

You will need an operation to remove a foreign body if it has penetrated inside the eye. This usually takes the form of a ‘vitrectomy’ – where part of the vitreous gel is removed from the middle of the eye. It involves going into the eye to remove the foreign material with fine surgical forceps.

At the same time, any damage to the eye caused by the entry of the foreign material can be repaired. This may involve:

• Removing a haemorrhage
• Removing the lens
• Suturing any defect of the globe
• Repairing any retinal damage.

Will there be any long-term effects?

Superficial foreign bodies are not sight-threatening injuries and the eye tends to make a full recovery. However, if you keep getting foreign matter in your eyes they may cause scarring and your vision may deteriorate.

Penetrating foreign bodies are potentially very serious and may lead to blindness or loss of the eye, even if treated appropriately.