Introduction
Foreign body removal is a technique used to remove foreign bodies such as rust, speck of dust, an insect or a wood chip from the eye.
The most common conjunctival and corneal injuries are inflicted by foreign bodies.
Definition
Foreign body removal is a therapeutic technique performed by an ophthalmologist or eye surgeon to remove a foreign body from the eye.
Purposes
- To remove the embedded foreign body from the eye.
- To reduce infection and inflammation.
- To alleviate discomfort.
Techniques
- The foreign body can be removed by eye irrigation.
- The embedded foreign body can be removed by slit lamp technique.
- Intraocular foreign bodies are treated surgically.
Indication
- Suspected ocular foreign body.
Contraindications
Absolute
- None.
Relative
- Identified or suspected intraocular foreign body or other penetrating injury which requires immediate ophthalmological consultation.
- An uncooperative patient.
Articles
| Articles | Purpose |
| Slit lamp | To visualize the eye. |
| Local anesthetic | To relieve pain. |
| Fluorescein strips | To check the surface of the eye for scratches. |
| 26- or 27-gauge needle attached to tuberculin syringe. | To instill the fluid. |
| Sterile saline | For cleansing the eye. |
| Emergency medication tray | To revive the patient in case of an emergency. |
Procedure
| Nursing Action | Rationale | |
| 1. | Explain the procedure to the patient. | Allays anxiety and gains cooperation from the patient. |
| 2. | Obtain informed consent from the patient. | Serves as legal evidence. Prevents litigation of the staff. |
| 3. | Instruct the patient to sit on a chair comfortably. | General preparation before the procedure. |
| 4. | Ask the patient to stabilize his or her head against the forehead band and place his or her chin on the chin rest of the slit lamp. | To keep the head steady. |
| 5. | Using a pen torch, examine the eye externally and specifically for visual acuity, ocular motion, and pupil size, shape, and reflexes. | Enhances the visualization of the eye. |
| 6. | Instill eye drops (topical ocular anesthetic) into the lower fornix of the affected eye. | To aid in performing the procedure. |
| 7. | Instruct the patient to close eyes for a minute. | |
| 8. | Examine the eye for foreign body by retracting the eyelid by placing your thumb and your forefinger above the upper lid. | To inspect the conjunctiva and cornea. |
| 9. | Using the slit lamp, examine a corneal foreign body and gauge its depth. | To plan the technique of removal. |
| 10. | Visualize the eye by lifting the upper eye lid upward and backward toward the patient. | To identify the presence of foreign body. |
| 11. | After identifying the foreign body, gently irrigate the area little away from the site and not over the foreign body, remove the superficial foreign body using sterile saline in a syringe. Using circular motion, remove the superficial foreign body using moist cotton applicator. | Irrigation dislodges the foreign body. |
| 12. | Removal of embedded foreign bodies. Instruct the patient to stare at an object straight ahead. | For clear visualization of the eye. |
| 13. | The embedded foreign body is removed by proceeding inward from the corneal. periphery using a 25- or 27-gauge syringe. Proceed from high-invasive to low-invasive area. | To prevent major injuries. |
| 14. | Hold the needle with the bevel up and use the tip to remove the object away from the cornea by means of rinsing the eye; repeat several times to remove fully. | Removes dust easily. |
| 15. | After removal of foreign body; Assess the visual acuity.Educate the patient regarding use of medicines such as topical antibiotic ointment or drops (e.g., ciprofloxacin 0.3% ointment or drops four times a day for 5-7 days) as per the physician’s order.Educate the patient not to apply pressure or patch over the eye. | To evaluate the procedure. |
| 16. | Document the procedure: Record the date, time, type of foreign body removed, and patient’s response to the procedure. | Serves as legal evidence and prevents duplication of care. |
Special Consideration
REFERENCES
- Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
- Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
- Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwers, ISBN-13:978-9388313285
- Adrianne Dill Linton, Medical-Surgical Nursing, 8th Edition, 2023, Elsevier Publications, ISBN: 978-0323826716
- Donna Ignatavicius, Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care, 11th Edition ,2024, Elsevier Publications, ISBN: 978-0323878265
- Lewis’s Medical-Surgical Nursing, 12th Edition,2024, Elsevier Publications, ISBN: 978-0323789615
- AACN Essentials of Critical Care Nursing, 5th Ed. Sarah. Delgado, 2023, Published by American Association of Critical-Care Nurses ISBN: 978-1264269884.
- Ernstmeyer K, Christman E, editors. Nursing Fundamentals [Internet]. 2nd edition. Eau Claire (WI): Chippewa Valley Technical College; 2024. PART IV, NURSING PROCESS. Available from: https://www.ncbi.nlm.nih.gov/books/NBK610818/
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