	Headline
History	- What type of foreign body? — e.g. dirt or organic material (higher risk of infection), glass, metal (rust ring may lead to inflammation and a corneal epithelial defect), inorganic material - Velocity of impact? — e.g. angle grinders, high speed drilling and ‘weed eater’ injuries are at risk of corneal or scleral penetration. - Symptoms? — foreign body sensation, tearing, blurred vision. - Use of eye protection?
Examination	Visual acuity as always Look for rust ring Tonometry? > Distortion of the cornea, anterior chamber, iris, pupil or lens indicates ocular penetration
Diagnostic investigations	Fluorescein examination - penetrating trauma, HZO
Differentials
Immediate management	- Irrigate - Topical LA → Remove FB if able - sterile cotton bud, beveled edge of a needle - Tetanus prophylaxis only if penetrating trauma
Ongoing management	Avoid wearing contact lens for >= 1/52 after defect fully healed or feels normal - No contact lens: cipro/ofloxacin topical - Yes contact lens: cover pseudomonas - levo/moxifloxacin, gent topical - Analgesia

Abrasion vs ulcer

	Abrasion	Ulcer
Presentation	Immediate pain	Pain 2-3 days after event
Visible on fluorescein exam?	Yes	Yes
Visible on white light?	No	Yes
Lesion looks...	Linear, punctate, patterned or irregular	Often circular

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