Compare conditions

Put any two — or three — conditions side by side, adult or pediatric, to spot the look-alike differences fast, row by row.

Foreign Body in the Eye

—

In one line

·Something small stuck on or in the eye, causing pain, tearing, and a scratchy feeling.

—

Normal physiology

·The front of your eye is covered by a crystal-clear, curved dome called the cornea, which bends light so you can see sharply. Over the white part of the eye and the inside of your eyelids lies a thin, clear skin called the conjunctiva. Together, the cornea and conjunctiva form a smooth, moist surface that lets your eyelid glide over your eye thousands of times a day without scraping. Tears made by glands above your eye constantly wash across this surface, rinsing away dust and germs and keeping everything slippery and healthy.

—

What goes wrong

·A tiny piece of something hard or sharp lands on the smooth, clear front of your eye or gets wedged under your eyelid. Instead of washing away, it sticks. Every time you blink, your eyelid drags it across the cornea, scratching the surface like sandpaper on glass. If the speck is moving fast — for example, a chip of metal from grinding or hammering — it can pierce through the cornea and go into the inside of the eye. Either way, the protective barrier is broken, nerves scream pain, and the door is open for germs to get in and cause infection.

—

Hallmark signs

—

Red flags · escalate now

·Severe pain that does not improve after rinsing or removing a surface object
·Sudden vision loss or large dark spots in vision
·Blood visible inside the colored part of the eye (hyphema) or behind the cornea
·Irregular or teardrop-shaped pupil (suggests rupture of the eyeball)
·History of high-speed impact (grinding metal, hammering, explosion) that could drive a particle deep into the eye
·Pus or thick discharge with fever or worsening redness spreading around the eye

—

Workup

—

Treatment

·Remove the foreign body with a moistened cotton swab or irrigation
·Topical antibiotic drops or ointment (erythromycin or polymyxin-trimethoprim)
·Rust-ring removal with a sterile needle or burr under the slit lamp
·Topical nonsteroidal anti-inflammatory drops (ketorolac or diclofenac)
·Cycloplegic drops (cyclopentolate or homatropine)
·Immediate ophthalmology referral and eye shield if globe rupture or intraocular foreign body is suspected

—

NCLEX trap

·Rubbing can scratch the cornea (the clear front window of the eye) or push the object deeper, causing more damage. Instead, flush the eye gently with clean water or saline and keep the eye closed until help arrives.
·If the object is stuck in the eye (not just floating on the surface), trying to pull it out can tear delicate tissue and worsen injury. Let a doctor remove embedded objects under proper lighting and magnification.
·Vision can stay normal even with a corneal abrasion (scratch on the eye's surface) or a small penetrating injury. Pain, tearing, light sensitivity, and the feeling that something is still there are warning signs that need a full eye exam, even if vision seems fine.
·Numbing drops stop the pain signal that protects the eye, so the person might rub or injure it further without realizing. They also slow healing. Use them only once in the clinic for the exam, then send the patient home with oral pain medicine and lubricating drops instead.

—

Install Maldek by Hill as an app — studies work even offline