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Referral
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Corneal abrasion/foreign body
Scope
Corneal abrasions are a result of trauma to the surface of the eye. Injuries can be caused by foreign bodies or by contact lens insertion and removal. Beware the possibility of a corneal ulcer in contact lens wearers. Ask about the use of power tools and consider the possibility of an intraocular foreign body if high velocity.
Signs and Symptoms
- Immediate pain
- Watering
- Foreign body sensation
- Photophobia
- Fluorescein drops will stain the abraded area
- Foreign body on conjunctiva or cornea
- Evert upper eye lid if any history of foreign body in the eye
- Watch out for signs of a corneal laceration such as a shallow anterior chamber or distorted pupil
If the presence of a corneal foreign body is confirmed, mechanically flush out irritants or foreign bodies with sterile eye irrigation solutions (Tear deficiency, ocular lubricants, and astringents)
Advise use of sunglasses for comfort
Consider oral analgesia for pain relief (Non-opioid analgesics and compound analgesic preparations) – please note many analgesic containing products are cheap to buy and are readily available over the counter along with advice from pharmacies.
Referral Criteria
- Metal foreign body not fully removed
- Any sign of penetrating eye injury/corneal laceration, refer Immediately
- Symptoms still present after initial treatment refer Urgently
NB Offer advice on the wearing of safety glasses, to prevent further injury
Referral instructions
EAST & NORTH
Specialty: Ophthalmology
Clinic Type: Cornea
Service: DRSS-Eastern and Northern-Ophthalmology-Optom Only-Devon ICB- 15N
If emergency – send direct to local hospital
Pathway Group
This guideline has been signed off by NHS Devon
Publication date: May 2022
