Answer: It is best to avoid manipulating or trying to remove the foreign object out of the eye to prevent further injury or increase infection risk. For similar reasons, the eye should not be flushed and tonometry should be avoided. In addition, a rigid eye shield (Fox shield) should be used to protect the eye.
All other components of the physical exam should be done.
General appearance: Anxious male on a stretcher
Vitals: Temp: 37C, BP: 140/80, HR: 102, RR 17,
Best Corrected Visual Acuity (BCVA): OD Hand Motion at 1 Foot, OS 20/20
Pupils: OD mydriatic, fixed, and peaked nasally, OS round and reactive
EOM: OD -2 adduction, OS full
Intraocular pressures: Deferred
External ocular exam:
Eyelids: OD laceration involving right eyebrow, OS flat
Conjunctiva: OD 3+conjunctival injection with 360 chemosis, apparent subconjunctival uveal prolapse nasally, OS white and quiet
Cornea: Clear OU
Anterior Chamber: OD formed, 60% hyphema, OS deep and quiet
Iris: OD peaked nasally, OS round and reactive
Lens: OD clear but partially subluxed inferiorly, OS clear
Dilated fundus exam:
Vitreous: OD +Vitreous hemorrhage, OS clear
There is no view posteriorly in the right eye. The left dilated fundus exam is WNL.
An external image of the right eye is shown below:
Above Image courtesy of Kyle Hirabayashi, MD
Click here for more information!