• Suspected foreign body or corneal abrasion.
• History of eye trauma or irritability in a nonverbal patient.
• Abnormal sensation or eye pain, foreign body sensation, photophobia.
• Examination gloves.
• Sterile isotonic irrigation solution (0.9% saline or
lactated Ringer’s). Tap water at room temperature is an
acceptable alternative to prevent treatment delay.
• Topical ophthalmic anesthetic solution (proparacaine 0.5% or
• Cotton-tipped swab.
• Eyelid retractor.
• Suspect an embedded eyelid foreign body when
no object can be visualized and symptoms are persistent.
• If possible, do not apply a topical ophthalmic anesthetic until
a foreign body is visualized or you are confident that none is present.
• Patients can help localize a foreign body but sensation will
be eliminated by the topical anesthetic.
• Patient’s inability to feel increases the potential
for abrasions since there is no further pain or apprehension with blinking,
eye movement, or rubbing.
• A smooth, uncoated metal clip can be bent to into an appropriate
shape to be used as a retractor after sterilization with alcohol.
• Copious irrigation and mechanical removal of a foreign body is
necessary to prevent corneal abrasions, infections, ulcerations,
perforations, and metallic rust rings.
• Eyelid margin: Junction of the internal and external
portions of the eyelid where the eyelashes are located.
• Palpebral fissure: Space between the upper and lower eyelid margins
when the eyelids are open.
• Medial commissure: Medial junction of upper and lower eyelids.
• Lateral commissure: Lateral junction of upper and lower eyelids.
• Lacrimal puncta: Located on the eyelid margin before the medial
• Conjunctiva: Thin transparent membrane.
• Palpebral conjunctiva: Covers the inner surface of the
• Bulbar conjunctiva: Covers the anterior portion of the eye except
for the central cornea.
• Fornix: Transition between the palpebral and bulbar conjunctiva.
• Muscles of the eyelid.
• Ask the patient to direct gaze downward.
• Grasp the eyelashes and distal upper eyelid between the index
finger and thumb and pull downward.
• Place a cotton-tipped swab across the mid-body of the upper eyelid.
• In a single maneuver, move the swab downward and pull the eyelid
upward (Figure 49–2), ...
Log In to View More
If you don't have a subscription, please view our individual subscription options below to find out how you can gain access to this content.
Want remote access to your institution's subscription?
Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.
If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.
AccessPediatrics Full Site: One-Year Subscription
Connect to the full suite of AccessPediatrics content and resources including 20+ textbooks such as Rudolph’s Pediatrics and The Pediatric Practice series, high-quality procedural videos, images, and animations, interactive board review, an integrated pediatric drug database, and more.
Pay Per View: Timed Access to all of AccessPediatrics
24 Hour Subscription $34.95
48 Hour Subscription $54.95
Pop-up div Successfully Displayed
This div only appears when the trigger link is hovered over.
Otherwise it is hidden from view.