Keeney A H
J Fam Pract. 1975 Oct;2(5):381-4.
Insults from corneal foreigh bodies range from trivial windblown debris through destructive chemicals, penetrating wounds, and severe secondary infection. History and preliminary examination should begin concurrently, particularly in the case of chemically active compounds. Needed auxiliaries are topical anesthetics, oblique light, magnification, sterile sodium fluorescein for diagnostic staining of surface breaks, removal instruments, and topical antibiotics to reduce the potential of secondary infection. A steadied, seated position for the physician, resting posture with hands supported on the face, and an oblique approach tend to reduce the likelihood of unwanted perforations or scars. An irrigating stream of sterile saline delivered through a 25 gauge short needle on a 5 cc syringe will dislodge most recent foreign bodies. The sterile needle is also available as a spud. Corneal thickness varies from slightly above 1 mm in the periphery to less than 0.5 mm centrally. Therefore, it is essential to have clear visualization of the foreign body in relation to corneal depth. Dislodgment into the anterior chamber or incidental perforation of the cornea generally require hospitalization, intensive antibiotics, and steroid therapy.
角膜异物造成的损伤程度不一，从轻微的风吹入眼的碎屑到具有破坏性的化学物质、穿透性伤口以及严重的继发性感染。病史询问和初步检查应同时进行，对于具有化学活性的化合物所致情况尤其如此。所需的辅助工具包括表面麻醉剂、间接检眼镜、放大镜、用于诊断表面破损的无菌荧光素钠、取出器械以及用于降低继发性感染可能性的局部用抗生素。医生采取稳定的坐姿，患者双手支撑面部保持休息姿势，并采用间接检眼镜检查法，这些措施往往能降低意外穿孔或形成瘢痕的可能性。通过连接在5毫升注射器上的25号短针输送无菌生理盐水冲洗液，可清除大多数近期进入的异物。无菌针也可作为异物剔除针使用。角膜厚度从周边略高于1毫米到中央小于0.5毫米不等。因此，清楚观察异物相对于角膜深度的位置至关重要。异物掉入前房或意外穿孔通常需要住院治疗，使用强效抗生素和类固醇疗法。
