Equis ISSN 2398-2977
Conjunctivitis: foreign body
Contributor(s): Paul E Miller, Graham Munroe
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
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Treatment
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Outcomes
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Further Reading
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