Subtarsal foreign bodies (on the inner lid surface) are a common reason for attendance to an emergency eye clinic. They occur more commonly inside the upper eye lid. There may be a history of trauma or feeling something blow into the eye.
Symptoms
- Foreign body sensation
- Watering
- Pain
Signs
- Visible subtarsal foreign body
- Red eye
- Linear corneal abrasion
Eye examination
- Observe conjunctiva and cornea with white light
- Instil 1 drop of proxymetacaine 0.5% with fluorescein 0.25%.
- Observe for corneal staining preferably using a blue light
- Evert upper eye: the presence of a subtarsal foreign body is confirmed
- Moisten a cotton bud with a few drops of sodium chloride 0.9%
- Gently remove the foreign body with the cotton bud, sweeping it away from the corneal surface
- Re-examine the eye to ensure the foreign body has been fully removed
Treatment
- Give patient foreign body information leaflet
- Give chloramphenicol ointment qds five days
- Offer advice e.g. on the wearing of safety glasses, to prevent another injury