Equis ISSN 2398-2977

Conjunctivitis: foreign body

Introduction

• Cause: usually of plant origin.
• Site: can become trapped in palpebral conjunctiva, fornices or bulbar surface of nictitans.
• Signs: usually - sudden onset unilateral ocular pain; more uncommonly - conjunctival granuloma.
• Diagnosis: adequate restraint, excellent magnification and lighting as well as analgesia are essential to conduct a thorough physical examination of the affected eye.
• Treatment: remove the foreign body (FB) if accessible and causing, or likely to cause, ocular irritation.
• Prognosis: guarded to good - depends upon type of FB and damage it causes.

Pathogenesis

Etiology

• Vegetable material, eg thorns, pieces of twigs or leaves.
• Other materials, eg flakes of metal or paint, hair, soil.

Pathophysiology

• Foreign material, particularly of plant origin, can become trapped in the palpebral conjunctiva, conjunctival fornices or bulbar side of the nictitans   →   signs ranging from no obvious discomfort   →   severe anterior segment pain.
• Penetration into the cornea, limbus, sclera or anterior chamber are more serious consequences.

• FB   →   typical acute onset of ocular pain.
• If ocular penetration occurs   →   above accentuated by severe uveitis   Uveitis: traumatic  .
• Penetration and retention of small FBs occasionally   →   a slowly growing granulomatous mass - probably due to a hyperplastic reaction.
• Occasional cases   →   only a mild inflammatory response (depends upon type and position of material) which may   →   misdiagnosis, inaction and chronicity.

Diagnosis

Treatment

Outcomes