Subtarsal foreign body

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