LESSON 1: Eye, Ear, Nose, and Throat (EENT) Surgery

Section I: EYE SURGERY

1-14

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1-14. PROCEDURES FOR REMOVAL OF INTRAOCULAR FOREIGN BODIES

a. General. The presence of an intraocular foreign body usually represents a serious ocular problem. Disturbance of the function of the eye results from several sources, including the destruction of or damage to the tissues caused by the entrance of a missile; infection introduced by the missile; and destruction of or damage to the delicate intraocular tissues caused by reactions to the intraocular intruder, such as siderosis caused by iron or inflammation caused by wood particles.

(1) Before surgery is undertaken, the size and location of the foreign body must be determined. This is done by special X-ray procedures of the skull with special bone-free X-ray using dental film and other techniques.

 

(2) In addition, metal-locating instruments and ultrasonic probes are employed to locate the foreign bodies.

b. Operative Procedures. The operation performed depends upon the size, location, and magnetic property of the embedded object. Local anesthesia is used because the cooperation of the patient is required.

(1) The magnet tip may be directed to the eye and the foreign body removed without incision into the eye if the size and location of the object makes this procedure feasible.

 

(2) If the size, shape (jagged edges), or the location of the foreign body is such that passage of the object would endanger structures vital to vision, the sclera is incised and the magnet tip is advanced into the vitreous, humor for removal of the object.

 

(3) A nonmagnetic foreign body is removed by incision and extraction, but it must be seen to be removed.

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