Corneal Foreign Body

Updated: Mar 22, 2016
  • Author: Mounir Bashour, MD, PhD, CM, FRCSC, FACS; Chief Editor: Hampton Roy, Sr, MD  more...
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Overview

Background

Corneal foreign body is foreign material on or in the cornea, usually metal, glass, or organic material.

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Pathophysiology

Corneal foreign bodies generally fall under the category of minor ocular trauma. Small particles may become lodged in the corneal epithelium or stroma, particularly when projected toward the eye with considerable force.

The foreign object may set off an inflammatory cascade, resulting in dilation of the surrounding vessels and subsequent edema of the lids, conjunctiva, and cornea. White blood cells also may be liberated, resulting in an anterior chamber reaction and/or corneal infiltration. If not removed, a foreign body can cause infection and/or tissue necrosis.

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Epidemiology

Frequency

United States

Foreign bodies are one of the most frequent causes of visits for ophthalmic emergencies. Sometimes, the foreign body may not be present at the time of examination, having left the residual corneal abrasion with resultant pain.

Superficial corneal foreign bodies are much more common than deeply embedded corneal foreign bodies. The possibility of an intraocular foreign body must always be considered when a patient presents with a history of trauma.

In major league baseball, 33% of all eye injuries are corneal abrasions; in the National Basketball Association, corneal abrasions account for 12% of all eye traumas.

International

No difference in frequency is observed internationally.

Mortality/Morbidity

Generally, superficial foreign bodies that are removed soon after the injury leave no permanent sequelae. However, corneal scarring or infection may occur. The longer the time interval between the injury and treatment, the greater the likelihood of complications.

If the foreign body fully penetrates into the anterior or posterior chambers, then it is officially an intraocular foreign body. In this case, eye morbidity is much more common. Damage to the iris, lens, and retina can occur and severely damage vision. Any intraocular foreign body can lead to infection and endophthalmitis, a serious condition possibly leading to loss of the eye.

Sex

Similar to other traumatic injuries, the incidence in males is much higher than in females.

Age

Similar to most other traumatic injuries, the peak incidence is found in the second decade and generally occurs in people younger than 40 years.

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