A patient comes in with complaint of a foreign body in their eye. Simple enough, right? This is one of those things in medicine that can be extremely satisfactory from a physician perspective. Find the problem, remove it, and the patient goes on their happy way.

But, there are a few things to remember.


If a patient presents with an eye complaint, document "ocular vital signs", as indicated.

1. Visual acuities

2. Visual fields

3. Pupils

4. Extraocular movements

5.  Intraocular pressure

If the foreign body is clearly visualized, use a cotton swab soaked in anesthetic, or a 25g needle to remove the object off the surface of the eye. If you opt for the needle, I like to cut the end off the cap to minimize any iatrogenic injury to the globe during removal. Make sure your approach to the eye is tangential, to avoid corneal injury. Usually a gentle flick is all that's needed. Make sure you invert the lids to check for additional remaining foreign bodies, and do a full fluoroscein exam to document the depth of injury.

Standard of care is broad-spectrum topical antibiotics +/- pain control depending on extent and depth of injury, as well as opthalmologic follow up within 24hrs.