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2.04 Conjunctival Foreign Body


Presentation

Low-velocity projectiles, like wind blown dust particles, can be loose in the tear film or lodged in a conjunctival sac. The patient may not be very accurate in locating the foreign body by sensation alone. On exam, normally occurring white papules inside lids can be mistaken for foreign bodies, and transparent foreign bodies can be invisible in the tear film (until outlined by fluorescein dye).

What to do:

What not to do:

Discussion

Good first aid (copious irrigation and not rubbing eyes) will take care of most ocular foreign bodies. The history of injury with a high velocity fragment such as a metal shard chipped off a hammer or chisel, should raise the question of a penetrating foreign body, and x rays should be obtained. Techniques for conjunctival foreign body removal can also be applied to locating a displaced contact lens, (see) but be aware that fluorescein dye absorbed by soft contact lenses fades slowly.

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Craig Feied, MD
Mark Smith, MD
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