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Something in the eye

There is something in my eye

The feeling usually means one of two things: something is still in there, or something was in there and left a scratch on its way past. Those two feel identical from the inside, and telling them apart takes a slit lamp and a drop of dye.

Close-up of a red, inflamed eye with a small dark foreign body embedded on the cornea beside the pupil

Stop and get emergency care if any of these apply

You were grinding, hammering, drilling or using a power tool when it happened — a fragment thrown at speed can pass through the wall of the eye and leave almost no mark, and it needs imaging, not a torch. The same goes for any chemical splash (irrigate with water for fifteen minutes first, then go), anything still embedded and visible, blood pooling in front of the iris, or a pupil that has changed shape. Go to an emergency room. For anything less dramatic, call 714-542-2226 and we will get you in.

Possible causes

What tends to end up in an eye

What entered the eye can matter just as much as where it landed. Some foreign materials cause only temporary irritation, while others can damage the cornea quickly and should be removed promptly.

Metal

By far the most common thing we remove, and the one with a deadline. Steel begins to oxidise against the wet cornea within hours, leaving a rust ring in the tissue around it. The fragment and the rust both have to come out, and the longer the wait the more tissue is involved.

Grit, sand and dust

Usually lands on the conjunctiva or washes into the tear film, and often rinses straight out. The ones that matter are the pieces that lodge under the upper lid, where they scrape the cornea with every blink.

Something under the upper lid

A lash, a grain of sand, a fleck of mascara. The giveaway is a scratchy eye with no visible cause and fine vertical lines across the top of the cornea — the tracks left by whatever is hiding up there. Finding it means turning the lid over, which takes about five seconds.

Glass and fiberglass

Fine glass is easy to miss and can be difficult to see against the cornea. Fiberglass splinters tend to arrive in numbers rather than singly, which means the examination has to be systematic rather than aimed at one spot.

Plant and organic matter

A thorn, a twig, a piece of bark. These carry a meaningfully higher infection risk than metal or glass because of what grows on them, and a scratch from vegetation is watched more closely than an equivalent scratch from a nail.

Contact lens fragments

A torn soft lens can leave a piece folded up under the upper lid long after the wearer is convinced the lens came out whole. If your eye has felt wrong since a lens tore, that is where to look.

Nothing at all

A corneal abrasion feels exactly like a foreign body that is still present, because the nerve endings cannot tell the difference. A good proportion of people who come in certain there is something in the eye have a clean scratch and nothing left to remove — which is genuinely good news.

Chemical splash

Not a foreign body in the usual sense, but it presents the same way and it is the one true emergency on this list. Irrigate with water for fifteen minutes before you do anything else, including phoning anyone. Alkalis — drain cleaner, cement, oven cleaner — do more damage than acids and do it faster.

Before you come in

What not to do in the meantime

Do not rub it. A loose particle sitting on the surface gets dragged across the cornea and turns a non-event into an abrasion. This is the single most common way a minor problem becomes a painful one.

Do not try to lift out anything embedded. A cotton bud against a stuck fragment removes corneal tissue around it rather than the fragment itself, and it widens the wound. Flushing with clean water or saline is fine and often works for loose debris; tweezers, fingernails and folded tissue are not.

Do not use anesthetic drops to get through the day. If you have been given numbing drops before, they are for the examination only. Repeated use stops the cornea healing and, kept up, can dissolve it. The relief is real and the cost is disproportionate.

Leave your contact lenses out from now until you have been seen, and bring the lens with you if it tore.

Chart of what not to do with a foreign body in the eye: do not rub the eye, do not try to remove it with tweezers or sharp tools, do not keep wearing contact lenses, do not put random drops or medications in, and do not ignore worsening pain or vision changes
The appointment

How removal actually goes

The procedure is typically more comfortable than patients expect. We work carefully to remove the foreign material while protecting the surface of the eye, and most patients can return home on their own afterward.

1. Numbing the eye

We begin with a topical anesthetic drop to make the examination and removal more comfortable. The drop may sting briefly, then quickly numbs the surface of the eye.

2. Locating the problem

Fluorescein dye and blue light help reveal scratches or defects on the cornea. We also carefully examine the eyelids because a foreign body can sometimes be hidden underneath them.

3. Removing the foreign body

Using the slit lamp for magnified visualization, loose material may be rinsed away while embedded particles are carefully removed with a fine ophthalmic instrument.

4. Treating a rust ring

Metallic foreign bodies can sometimes leave a rust deposit in the cornea. When appropriate, the remaining rust can be carefully removed to promote healing and reduce ongoing irritation.

5. Protecting the eye afterward

Depending on the injury, treatment may include antibiotic drops or ointment and other medications to improve comfort while the corneal surface heals. Contact lens wear is usually paused until healing is complete.

6. Follow-up and healing

Many superficial corneal injuries heal quickly, but follow-up may be recommended to confirm that the cornea is closing properly and that infection or other complications are not developing.

Booking a visit

When something in the eye needs seeing today

Most specks wash out or work loose on their own. The signs below are different: they suggest something is still in there, or that the eye has been injured more deeply than it looks from the outside.

Chart of signs that a foreign body in the eye needs to be seen: persistent pain or gritty feeling, redness that does not improve, excess tearing, a sensation that something is still there, light sensitivity, blurred vision, trouble keeping the eye open, and symptoms that are getting worse
Good to know

Questions about something in the eye

For a speck of dust that has already rinsed away and an eye that feels normal, yes. For anything metal, no — steel starts staining the cornea within hours and the rust ring grows the longer it sits. And an eye that still feels gritty the next morning has either something left in it or a scratch that should be looked at.

The anesthetic drop stings briefly, and after that the removal itself is not painful. Most people find the anticipation considerably worse than the procedure. You will feel some pressure and see bright light; that is about the extent of it.

Because the scratch left behind sends the same signal as the object did. That sensation typically fades over the following day or two as the surface closes. What is not normal is pain that increases after the first day — that warrants another look.

Superficial abrasions heal without a trace. A deep foreign body in the center of the cornea can leave a small opacity, and whether that affects vision depends on exactly where it sits. Most do not. Infection is the thing that turns a minor injury into a scarring one, which is the reason for the antibiotic and the follow-up.

Emergency room for high-velocity injuries, chemical splashes, anything that may have penetrated the eye, and anything at all when we are closed. Otherwise an optometry practice is usually the better option — we have the slit lamp and the removal instruments in the room, which most urgent care clinics do not.

Dr. Mai is certified in the treatment and management of ocular disease and removes corneal and conjunctival foreign bodies here, rust rings included. Referral is for cases involving penetration of the eye or damage beyond the front surface, which are a different problem and belong with a surgeon.

Something in your eye right now?

Call and describe what happened and what you were doing. We will tell you right away whether this is a same-day visit here or an emergency room.

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