Definition Foreign bodies, such as dust, dirt, sand, wood particles, and metal fragments, blown or rubbed into eyes, causing corneal abrasion, a loss of the surface epithelial layer of the cornea. Characteristics Eye redness and burning sensation, pain, headache, photophobia, and tear overproduction. Policy Evaluate employee in the occupational health unit and arrange immediate medical care to remove embedded foreign body or to treat corneal abrasion. Do not remove embedded for- eign body. Objectives Clinical Assessments and Interventions Referral for Medical Action 101 200 Eye Injury: Foreign Body or Corneal Abrasion ● Embedded, protruding, or perfo- rating foreign-body injury. ● Foreign body on cornea after irri- gation and apparent “rust ring.” ● Substantial or prolonged symp- toms. ● Pain after foreign body removal. Follow-up Actions ● Instruct not to rub eye. ● Discuss importance of eye protec- tion. ● Conduct worksite assessment with other members of occupational health team to identify potential hazards and prevention strategies. ● Arrange for periodic eye examina- tions to evaluate visual acuity as needed. ● If eye anesthetic was used, sug- gest wearing safety glasses eye might be insensitive until medica- tion wears off. ● Counsel regarding return to work or limited duty as indicated. Determine extent and severity of injury. Remove foreign body (if not embedded). Prevent infection. ● Assess injury. ● Assess eye for contact lens and remove, if able. ● Obtain history of the injury, including type of work performed and tools used. ● Based on history, symptoms, and situation, test visual acuity. ● Have employee blink several times to try to dislodge foreign body. ● Apply anesthetic eye drops per standing order. ● Gently irrigate eye with sterile isotonic or electrolyte or balanced salt solution to remove foreign material on lids or around eye. ● Attempt to locate foreign body by inspecting eye with aid of magnifying lens. Gently evert upper eyelid to inspect inner lid surface. ● If foreign body is on cornea, try to remove with irrigating solution inspect for corneal “rust ring” or injury, using Fluor-i-strip as needed. ● If foreign body appears to be superficially lodged in eye, try to remove by irrigating eye with sterile irrigating solution (directing stream to one side of foreign body). ● If irrigation is not successful, use small, sterile applicator moistened with sterile irrigating so- lution, rolling applicator gently over foreign body, away from center of pupil. ● Assess visual acuity following removal. ● Refer to ophthalmologist if foreign body does not float out easily. ● Review employee tetanus status (see Guide- line 15, Tetanus Prophylaxis, page 40). Guideline continues on next page