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Corneal superficial injury - Management
How do I remove a corneal foreign body?

  • Only remove a corneal foreign body if you are confident and experienced with this procedure.
  • Use a topical anaesthetic such as tetracaine, oxybuprocaine, or proxymetacaine to prevent pain during the examination.
    • Refer to secondary care if the topical anaesthetic does not remove the pain (a more serious problem may exist).
  • Irrigate the eye with water, or remove the foreign body with a cotton wool bud or a triangle of card.
    • If this is unsuccessful, and only if you are experienced, carefully lift the foreign body using the tip of a sterile 25-gauge needle.
    • Refer to secondary care if you are not experienced in this procedure, or this is unsuccessful.
  • Evert the upper lid to exclude a subtarsal foreign body, particularly if there are vertical corneal scratches or a feeling that the foreign body is still there. This should never be done if there is any possibility of a penetrating eye injury, as the contents of the eye may prolapse.
  • Advise the person that 10–15 minutes after the numbing effect of the drops have worn off, the eye may feel uncomfortable until the abrasion heals.
Basis for recommendation
  • These recommendations are based on published expert opinion [Khaw et al, 2004a].
  • Removing a foreign body: corneal foreign bodies are often more difficult to remove if they are metallic because they may be rusted on. If they are not removed they will prevent healing and rust may permanently stain the cornea.

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