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Richmond Eye Associates
Eye Health and Disorders
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Introduction: "Foreign body sensation"
The sensation that something is in
the eye commonly brings people to the ophthalmologist. This is referred to as a
"foreign body sensation", as if a foreign object were scratching the eye.
Usually this sensation originates from the cornea, which is the clear part of
the eye through which we see. The cornea has a large number of nerve fibers that
are normally covered by a lining. If this lining is breached, the sensation that
something is in the eye results, whether or not anything is actually there.
Any condition which can cause a scratch on the cornea can lead to this symptom.
Some causes are detailed on this page. There are also links to other Symptom and
Diagnosis pages based on other symptoms in addition to the foreign body
sensation.
Read this important information
before proceeding further:
These sections are not intended to replace the professional examination and
diagnosis by a physician, and they are presented here purely for informational purposes.
All possible diagnoses and treatment options are not covered, and the information
discussed should not be taken as a recommendation to self-diagnose and self-treat a
condition. A misdiagnosed or improperly treated eye condition can result in a permanent
loss of vision, or a permanent loss of function of the eye or visual system. In the case
of any eye problem, seek medical attention promptly. This can include emergency room
treatment, as well as treatment by a medical physician or eyecare provider.
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Conditions Discussed on this Page:
For eye anatomy explanations, go to
ANATOMY
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"Dry eye" is a common ocular
problem, as is evidenced by the large number of artificial tear preparations
available over-the-counter. There may be a tendency for tear production to
decrease with aging, and dry eye problems may be associated with certain
arthritis syndromes, such as Sjogren's syndrome and rheumatoid arthritis.
However, many people can develop a problem with ocular dryness with no
apparent underlying cause.
Symptoms of dry eye include a sensation of dryness or grittiness, foreign
body sensation, burning, redness, and generalized eye fatigue. The vision
may blur or fluctuate. The eyes may seem sensitive to changes in temperature
and to wind. Paradoxically, tearing may be a symptom of ocular dryness.
Tearing can occur because the glands that produce tears in large quantities
are not usually involved much in the minute to minute lubrication of the
eyes. If the eye reach a certain level of dryness, this large tear gland
becomes activated and produces excessive tears.
Symptoms of dry eye can have other causes than just reduced tear production.
Oil producing glands in the eyelids provide a layer of oil on the surface of
the eye which helps to prevent tears from evaporating. If this oil layer is
deficient, as in certain types of blepharitis, the eyes can become dry much
too quickly. Similarly, mucous helps to lubricate the eye, and if this is
deficient, dry eye symptoms can result. Oral antihistamines may dry the eyes
in this way. The ophthalmologist can determine the principle cause of the
dryness symptoms, and direct therapy in the right direction.
Supplemental lubrication of the eye is the main treatment for dry eye. There
are numerous artificial tears available. Generally, preservative free eye
drops are recommended in people who have to use eye drops frequently and on
a daily basis. Some preparations, such as Celluvisc and Refresh Liquigel,
are thicker than most other artificial tears, and may provide more long
lasting relief in some cases. Lubricant ointments are also available (such
as Refresh P.M.). These are generally used at bedtime (since the vision is
extremely blurred for a period of time after their use), but may give
substantial relief.
Newer over the counter options for dry eye include Systane, which improves
the ability of natural tears or other artificial tears to remain on the
ocular surface, and Soothe, which reduces the evaporation of tears from the
eye.
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Other options for treating dry eye include treating any other problems, such
as blepharitis. Sometimes oral antibiotics may help. In severe cases,
occlusion of the tear drainage system may help the tears to stay longer on
the eye itself. Restasis is prescription eye drop which has been found
to improve tear production when used over a period of weeks to months.
Often the treatment of dry eye requires a combination of different types of
eye drops to promote healing of the ocular surface and to maintain
lubrication.
Return to Condition List
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A corneal abrasion is a break in
the surface layer of the cornea, which is the clear part of the eye through
which we see. This usually follows obvious trauma, although an abrasion may
occur from other causes, such as an inturned eyelash or from an eyelid
infection (blepharitis).
Symptoms include pain, redness, tearing, sensitivity to light, and blurred
vision. The "foreign body" sensation can be severe, and often people describe
symptoms of a "rock were rolling around under the eyelid". What is actually
being felt is this extremely sensitive exposed part of the cornea touching the
inside of the lid as the eye blinks.
Diagnosis and treatment should be made by an ophthalmologist. If trauma is
involved, the eye must be thoroughly examined to rule out and other injury.
Treatment is usually by patching of the eye with antibiotic ointment, or
frequent use of antibiotic ointment or lubricating medication. There is risk
of infection (corneal ulcer) and internal ocular inflammation (iritis) with
this condition. Fortunately, under good circumstances, the cornea can heal
rapidly, sometimes even overnight.
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Trichiasis refers to misdirected
eyelashes, where they point backwards and irritate the eye surface. Symptoms
are usually of a foreign body sensation, but more severe symptoms of redness,
pain, tearing, and light sensitivity are not uncommon. Treatment is by
removing the offending eyelash (epilation), and by providing protective
treatment for any corneal injury which may have occurred. With recurrent
inturned eyelashes, electrolysis may permanently remove the eyelash, although
more than one treatment may be necessary.
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A foreign object can lodge
itself onto the cornea and cause significant symptoms of pain, tearing,
light sensitivity, and blurred vision. Except in cases of obvious trauma
where debris strikes the eyes, the most common corneal foreign body is a
rusted metallic particle. Small shards of metal seem to have an almost
magnetic attraction to the corneal surface, where they rapidly rust and
become embedded. The use of safety goggles with any type of drilling,
hammering, etc. can be preventative. As the rusted particle sits on the
cornea, the eye becomes progressively more irritated over a period of days
with redness, pain, light sensitivity, and tearing. Often the particle is
visible on the eye, but it may be nearly microscopic. The ophthalmologist
has the equipment necessary in the office to remove these foreign bodies.
Usually a scar remains, and there is risk of infection.
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Debris which gets into the eyes
can become trapped under the upper eyelid. This will lead to worsening
symptoms of foreign body sensation, pain, tearing, and redness. The debris
can be nearly anything, and plant material (wood) is not uncommon. A large
foreign body under the lid rapidly becomes intolerable, with a corneal
scratch occurring every time the eye blinks. Obviously, removal of the
foreign body is curative.
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After the cornea is scratched,
it can heal superficially very rapidly to cover the defect. However, a
longer period of time (months) is required for this area of healing to
become firmly bonded in place. In some people, an area of corneal injury may
be permanently weakened. In this situation, minimal trauma to the eye may be
enough to cause this area of weakening to slough off, leading to a corneal
abrasion again. This "minimal trauma" can include things as simple as eye
rubbing or the eye opening for the first time in the morning.
This second situation is the most common. Typically, people with a recurrent
corneal erosion problem experience ocular pain upon awakening. The eye may
tear and have foreign body sensation. The corneal defect rapidly heals over
in most cases, and the symptoms resolve in minutes to hours. However, the
process may repeat itself the next morning. Some people may have an
underlying weakness of the cornea (map-dot-fingerprint dystrophy), and can
develop these symptoms with no history of trauma in the past.
Treatment is first to diagnose the problem, and then initially to try using
lubricating ointments on the eye at bedtime. Sometimes these have to be used
for weeks to months. Commonly used lubricants include Refresh P.M. and Muro
128. These lubricants help to prevent the eyelid from pulling open the
corneal scratch upon awakening in the morning. In cases where the problem
continues in spite of treatment, there are procedures which can be done in
the ophthalmologist's office to reinforce the weakened area.
Return to Condition List
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Blepharitis - itching, burning,
eyelid irritation.
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Conjunctivitis - eye redness,
itching, discharge.
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Contact lens related problems - may have
pain, scratchy sensation, redness, lens intolerance.
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Ectropion (out-turning) of eyelid -
scratchy sensation, pain, tearing.
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Entropion (in-turning) of eyelid -
scratchy sensation, pain, tearing and discharge.
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Eye Medication toxicity - corneal
irritation from eyedrops can lead to scratchiness.
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Phlyctenulosis - sensation
that something is in eye, burning, itching, blepharitis.
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Pterygium - a growth on the surface
of the eye, often with redness.
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Ocular cicatricial phemphigoid -
an autoimmune disorder that leads to conjunctival scarring and dry eye symptoms.
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