The treatment of<unk> s aims to prevent bacterial superinfection, speed healing, and provide symptomatic relief. If a foreign body is found, it needs to be removed. Foreign body * Positioning: The person is laid in a comfortable position with the affected eye closest to the physician. Loupes<unk> n be used if available and the eye<unk> n be illuminated with a medical light or, alternatively, with an ophtalmoscope held in the non-dominant hand. The person is then asked to focus on a particular point on the ceiling so that the foreign body sits as centrally between the eyelids as possible. This accounts for a more sterile procedure by keeping the eyelashes as far as possible, and reduces the chance of eliciting a blink reflex. If necessary, the eyelids<unk> n be kept open using an eyelid speculum, the examiner’s fingertips, a cotton tip or an assistant. * Anaesthetic and pupil dilator: Local anaesthetic is instilled into both eyes in order to reduce blepharospasm. Topical oxybuprocaine 0.4% is the preferred choice as it has an onset of action of 20 seconds and a half-life of 20 minutes. A drop of topical pupil dilator such a cyclopentolate 1%, if available,<unk> n be helpful to reduce ciliary spasm after removal of the foreign body. Atropine is generally avoided due to its long-lasting mydriatic effects. * Removal techniques: There are mainly two types of techniques, the choice of which will depend on the nature of the foreign body. The first technique is the cotton tip removal, which is indicated in superficial foreign bodies with no surrounding corneal reaction, and the second is the hypodermic needle or nº15 blade removal with which the complete foreign body and any surrounding rust ring<unk> n be removed. * Irrigation of the ocular surface and upper and lower fornices<unk> n be performed after the procedure to wash out any residual loose foreign body material. A 10 mL ampoule of sterile saline is usually sufficient. Medications Current recommendations stress the need to use topical and/or oral analgesia and topical antibiotics. One review has found that eye drops to numb the surface of the eye such as tetracaine improve pain; however, their safety is unclear. Another review did not find evidence of benefit and concluded there was not enough data on safety. Topical nonsteroidal anti-inflammatory drugs (NSAIDs) are useful to reduce the pain<unk> used by<unk> s. Diclofenac and ketorolac are the most used, one drop four times a day. It is worth noting, however, that diclofenac may delay wound healing and ketorolac should be avoided in people who wear contact lenses. Some studies do not recommend using topical NSAIDs due to the risk of corneal toxicity. There is no direct evidence regarding the use of oral analgesics, but because pain relief is the main concern for people with<unk> s, these are prescribed according to individual's characteristics. Topical antibiotics are used to prevent concomitant infections, which result in slower healing of<unk> s. Ointments are considered the first-line treatment, as they are more lubricating than drops. If the person uses contact lenses, an antibiotic with anti-pseudomonal activity is preferred (ciprofloxacin, gentamicin or ofloxacin), and the use of contact lenses should be discontinued until the<unk>  has healed and the antibiotic treatment has ended. This is because contact lens wearers are often colonized with Pseudomonas aeruginosa, which may<unk> use corneal perforations and subsequent permanent vision loss. If the mechanism of injury involves contact lenses, fingernails or organic/ plant matter, antibiotic prophylaxis should be provided with topical fluoroquinolone drops 4 times a day, and a fluoroquinolone ointment, typically ciprofloxacin, at night. If the<unk>  was<unk> used by another mechanism, the recommended treatment includes antibiotic ointments (erythromycin, bacitracin or bacitracin/polymyxin B every 2 or 4 hours) or antibiotic drops, usually polymyxin B and trimethoprim 4 times a day. Patching Eye patching is not generally recommended as they do not help with healing or pain. Furthermore, it<unk> n result in decreased oxygen delivery, increased moisture and a higher chance of an infection. Another measure that is no longer recommended is the use of mydriatics, formerly used to relieve the pain<unk> used by ciliary muscle spasm.
Corneal abrasion
Globe rupture
Corneal ulcer
Corneal perforation
Baby colic
Orbital emphysema
Pitted keratolysis
Band keratopathy