[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Ophthalmology](https://durgical.com/en/ophthalmology/) › [Ocular emergencies and trauma](https://durgical.com/en/ophthalmology/areas/emergencies/) › Corneal and subtarsal foreign bodies # Corneal and subtarsal foreign bodies - Emergency A speck in the eye is found with fluorescein and lid eversion. Most come off with irrigation or a swab; deep, central or high-speed ones go to ophthalmology. Updated Nov 5, 2026 **See it in 3D:** [Cornea](https://durgical.com/en/anatomy/cornea/) · [Eyelids](https://durgical.com/en/anatomy/superior-tarsus/) ## Key points - Always evert the upper lid. - Hammering metal on metal = rule out an intraocular foreign body (CT). - No anaesthetic drops to take home. - Topical antibiotic and review in 24 to 48 hours. ## What it is Corneal and conjunctival foreign bodies (metal, wood, dust, insects) are among the commonest eye injuries, especially at work. They cause a gritty pain, tearing and light sensitivity. Most are superficial and can be removed in the emergency room after a topical anaesthetic. The key is to not miss a particle under the upper lid, a penetrating injury or a retained intraocular fragment. ## How to recognise it - High-speed mechanism (hammering, grinding, drilling): possible intraocular foreign body. - Vertical scratches on the cornea: a particle under the upper lid. - A positive Seidel test, a peaked pupil or a shallow anterior chamber: penetrating injury. - A white infiltrate around the particle: infection. - Plant material: risk of fungal keratitis. ## What to do at once - Ask the mechanism and measure visual acuity. - Instil a topical anaesthetic and fluorescein, and look with a bright light and magnification. - Evert the upper lid and sweep the fornix with a moist swab. - Try irrigation first, then a moist cotton swab for a superficial particle. - Embedded particles are lifted at the slit lamp with a fine needle by a trained clinician; a rust ring is removed by ophthalmology. - Give a topical antibiotic and analgesia; patching is not needed. - Review within 24 to 48 hours. ## Mistakes that cost sight - Topical anaesthetic drops are for the examination only: repeated use at home damages the cornea and hides complications. - A metal fragment leaves a rust ring within hours, which slows healing if left. - X-ray or CT of the orbits is needed whenever an intraocular fragment is possible. ## Next step / Initial management - Superficial particle removed: topical antibiotic, oral analgesia and review in 24 to 48 hours. - Refer to ophthalmology the same day: deep or central particles, a large rust ring, failure to remove, a corneal infiltrate, plant matter or suspected penetration. - Suspected intraocular foreign body: shield the eye, CT of the orbits and emergency referral. - Advise eye protection at work. ## Test yourself Think of the answer, then tap the question to see it. ## What do vertical linear scratches on the cornea suggest? A foreign body trapped under the upper lid; the lid must be everted. ## Which history makes an intraocular foreign body likely? Hammering metal on metal, grinding or drilling: small high-speed fragments can enter the eye. ## Why are topical anaesthetic drops not given to take home? Repeated use delays healing, can cause corneal ulceration and masks worsening symptoms. [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/ophthalmology/corneal-and-subtarsal-foreign-bodies/) ## Connections ## See it in 3D 2 The structures of Durgical's 3D anatomy where it is found. - [Cornea](https://durgical.com/en/anatomy/cornea/) - [Eyelids](https://durgical.com/en/anatomy/superior-tarsus/) ## Related 5 - [Everting the eyelid](https://durgical.com/en/ophthalmology/everting-the-eyelid/) - [Fluorescein staining and the Seidel test](https://durgical.com/en/ophthalmology/fluorescein-staining-and-the-seidel-test/) - [The slit lamp: what each light shows](https://durgical.com/en/ophthalmology/the-slit-lamp-what-each-light-shows/) - [Topical anaesthetics: why they are never sent home](https://durgical.com/en/ophthalmology/topical-anaesthetics-why-they-are-never-sent-home/) - [Suspected open globe: the first steps](https://durgical.com/en/ophthalmology/suspected-open-globe-the-first-steps/) ## Related conditions 3 - [Corneal abrasion and ocular foreign body](https://durgical.com/en/conditions/corneal-abrasion-and-ocular-foreign-body/) - [Keratitis and corneal ulcer](https://durgical.com/en/conditions/keratitis-and-corneal-ulcer/) - [Ocular trauma: hyphema and open globe injury](https://durgical.com/en/conditions/ocular-trauma-hyphema-and-open-globe-injury/) ## In Pharmacology 3 - [Tetracaine](https://durgical.com/en/pharmacology/tetracaine/) - [Fluorescein](https://durgical.com/en/pharmacology/fluorescein/) - [Chloramphenicol](https://durgical.com/en/pharmacology/chloramphenicol/) [← All of ophthalmology](https://durgical.com/en/ophthalmology/) Educational content; not a clinical guideline and no substitute for assessment by a health professional. For sudden visual loss, severe eye pain, a chemical burn or an eye injury, go to an emergency department at once. Sources: [Corneal Foreign Body](https://www.ncbi.nlm.nih.gov/books/NBK536977/) (StatPearls Publishing (NCBI Bookshelf), 2025); [Corneal Foreign Body Removal](https://www.ncbi.nlm.nih.gov/books/NBK554478/) (StatPearls Publishing (NCBI Bookshelf), 2023); [Corneal Abrasion](https://www.ncbi.nlm.nih.gov/books/NBK532960/) (StatPearls Publishing (NCBI Bookshelf), 2024). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/ophthalmology/corneal-and-subtarsal-foreign-bodies/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/ophthalmology/corneal-and-subtarsal-foreign-bodies/