eyelid foreign body
Introduction
Introduction When foreign bodies in the eyelids are more common in explosive wounds, the upper and lower eyelids can be covered with fine powder of gunpowder, dust and sand, and larger foreign bodies can be pinched out with tweezers.
Cause
Cause
The cause of foreign bodies in the eyelids:
More common in blast injuries, the upper and lower eyelids can be covered with fine gunpowder, dust and sand.
Examine
an examination
Related inspection
Eyelid examination and CT examination of the temporal region
Examination and diagnosis of foreign bodies in the eyelids:
1. History of trauma: such as knocking metal history, blast injury, etc. A small number of patients may have no history of conscious trauma.
2. Clinical manifestations: often accompanied by symptoms and signs of eyeball perforation. According to the size, nature and injury of foreign bodies, the clinical performance can be varied in the morning and evening.
3. Examination of wounds and wounds: It is found that perforated wounds are an important basis for the diagnosis of foreign bodies in the ball. Such as corneal wound or full-thickness scar, the corresponding iris has small holes, crystal turbidity, indicating that foreign matter enters the eye, scleral wound is difficult to find, should be judged according to eye examination and auxiliary examination. Foreign objects in the anterior chamber, crystal, vitreous and fundus, if the refractive interstitial is still transparent, can be seen directly under the slit lamp or ophthalmoscope. If necessary, it should be used for vestibular or three-sided mirror inspection.
Diagnosis
Differential diagnosis
Eyelid foreign body confusing symptoms:
1. Foreign objects outside the ball:
1. Orbital foreign body: more common in blast injury, the upper and lower eyelids can be covered with fine powder of slag, dust and sand, and larger foreign objects can be clipped with tweezers.
2. Conjunctival foreign bodies: common dust, coal dust, etc., more hidden in the lower ditch of the seesaw, sacral and half-moon folds, foreign body rubbing the cornea can cause irritation. After using the topical anesthetic to spot the eye, wipe off the foreign body with a cotton swab and then apply antibiotic eye drops.
3. Corneal foreign body: See more coal dust and iron filings, and obvious irritation, such as tingling, tearing, eyelids, etc. Iron foreign matter can form rust spots, and plant foreign matter can easily cause infection. For shallow foreign body of the cornea, under the surface anesthesia, wipe it with a saline wet cotton swab. Deeper foreign matter can be removed with a sterile injection needle. If there is rust, try to scrape it off once. For a plurality of foreign objects, it can be taken out in stages, that is, the exposed shallow foreign matter is discharged first, and the foreign matter buried in the deep layer of the cornea can be temporarily not treated. If the foreign body is large and has partially penetrated the cornea into the anterior chamber, foreign body extraction should be performed in the operating room, and the corneal wound should be sutured if necessary. Sterile operation should be strictly performed when picking out corneal foreign bodies. After taking out foreign body, take antibiotic eye drops or eye ointment, bandage the injured eye and promote corneal healing.
4. Eyelid foreign bodies: Common scorpions are metal shrapnel, gas bombs, or wood and bamboo chips. There may be local swelling and pain. If a purulent infection is combined, it can cause cellulitis or sputum. Since the metal foreign bodies in the sputum are mostly wrapped by soft tissue, and the deep sacs have fine structures such as nerves, blood vessels and muscles, such foreign bodies in the deep part of the sputum may not be barely extracted. Botanical foreign bodies can cause chronic suppurative inflammation and should be removed as soon as possible.
Second, foreign objects in the ball:
Foreign bodies in the ball are eye injuries that seriously threaten vision. The damage of foreign bodies includes mechanical damage, chemical and toxic reactions, transdermal infections and consequent sequelae of foreign bodies on the structure of the eye. For example, foreign matter passing through the cornea, crystals can cause corneal perforation, pigmented membrane incarceration, corneal opacity and cataract; crossing the pigmented membrane or retina can cause intraocular hemorrhage. Iron foreign bodies dissolve and oxidize in the eye, which has obvious toxic effects on the retina. Iron oxide binds to tissue proteins to form insoluble ferritin, which is deposited in various tissues and is characterized by brown deposits called ocular rust, which can cause vision loss. Foreign bodies containing more than 80% of copper can cause acute aseptic septic inflammation. Copper deposition in the eye can cause rust, brown-yellow pigmentation in the posterior corneal elastic layer, and sunflower-like opacity on the anterior capsule of the lens. Foreign matter is brought into pathogenic microorganisms, which can cause intraocular infection and blindness. The clinical manifestations of foreign bodies in the ball are often related to various factors mentioned above.
It should be considered based on the following points:
1. History of trauma: such as knocking metal history, blast injury, etc. A small number of patients may have no history of conscious trauma.
2. Clinical manifestations: often accompanied by symptoms and signs of eyeball perforation. According to the size, nature and injury of foreign bodies, the clinical performance can be varied in the morning and evening.
3. Examination of wounds and wounds: It is found that perforated wounds are an important basis for the diagnosis of foreign bodies in the ball. Such as corneal wound or full-thickness scar, the corresponding iris has small holes, crystal turbidity, indicating that foreign matter enters the eye, scleral wound is difficult to find, should be judged according to eye examination and auxiliary examination. Foreign objects in the anterior chamber, crystal, vitreous and fundus, if the refractive interstitial is still transparent, can be seen directly under the slit lamp or ophthalmoscope. If necessary, it should be used for vestibular or three-sided mirror inspection.
