Signs depend on site of foreign body, eg conjunctival, corneal, behind third eyelid, intraocular and nature of foreign body, eg plant material, metallic.
Conjunctivitis.
Chemosis.
Keratitis.
Intraocular hemorrhage with penetration.
Blepharitis.
With chronic damage to the eye there may be corneal ulceration and corneal edema plus iris or choroidal damage.
Iris prolapse with penetration.
Cataract.
Diagnostic investigation
2-D Ultrasonography
For location of intraocular and retrobulbar foreign body.
Metallic foreign bodies produce high amplitude echoes.
Other
Ophthalmoscopy may be helpful if the foreign body is small (direct most useful).
Local anesthesia (topical) and/or general anesthesia.
CT/MRI for localization of orbital and ocular FB. Do not use CT if FB is metallic
Confirmation of diagnosis Discriminatory diagnostic features
History.
Signs.
Definitive diagnostic features
Identification of foreign body. Not always obvious, examine particularly in conjunctival fornices and behind third eyelid.
Always remove corneal foreign body as soon as possible.
Exception may be cases of intraocular airgun pellets which may be best left alone unless obvious in anterior chamber. Remove corneal foreign bodies using 2 hypodermic needles on either side of the foreign body with lifting motion. Do not try to grasp with forceps as this usually pushes the foreign body further into the eye - so much depends on size, shape and position.
Standard treatment
Antibiotic eye ointment following removal, probability of infection or ulceration in many cases.
Atropine and NSAIDs for secondary uveitis.
Systemic antibiotics.
Subsequent management
Monitoring
If very severe painful uveitis in a blind eye, risk of developing glaucoma is high, and the eye may be best treated by enucleation.
Dr Keith Barnett DipECVO MA PhD BSc DVOphthal FRCVS OBE , Consultant in Ophthalmology, Animal Health Trust, Lanwades Park, Kentford, Newmarket, Suffolk CB8 7UU, UK.
Dr Dennis E Brooks DVM PhD DipACVO , College of Veterinary Medicine, 2015 SW 16th Ave, University of Florida, PO Box 100126, Gainesville, FL 32610-0126, USA.
Dr David L Williams MA VetMB CertVOphthal PhD MRCVS , Department of Clinical Veterinary Medicine, University of Cambridge, Madingley Road, Cambridge CB3 0ES, UK.
reflex uveitis if left and focal keratitis with ulceration (not always ulceration).
Do not use CT if FB is metallic
Remove corneal foreign bodies using 2 hypodermic needles on either side of the foreign body with lifting motion. Do not try to grasp with forceps as this usually pushes the foreign body further into the eye - so much depends on size, shape and position.