Evaluating the need for close follow-up after removal of a noncomplicated corneal foreign body.

Overview

PURPOSE: The purpose of this study was to evaluate the need for close follow-up after removal of noncomplicated corneal foreign bodies. METHODS: This is an observational prospective cohort study of 60 eyes in noncontact lens wearers with corneal foreign bodies outside the visual axis. Foreign bodies were removed and patients were followed as per the Wills Eye Manual guideline for 1 to 3 days after foreign body extraction, and every 3 to 5 days until resolution of the epithelial defect. Patients were asked to record their symptoms of eye pain, eye irritation, eye redness, and visual acuity on a visual analog scale to monitor symptoms related to development of infectious keratitis. The primary endpoint was resolution of the epithelial defect. RESULTS: The average time to resolution of the epithelial defect was 4.34 ± 1.56 days, with an average of 2.2 ± 1.23 follow-up visits after removal. One patient developed infectious keratitis (1.67%). Symptoms showed a statistically significant improvement in patients who had healed epithelial defects, and a statistically significant worsening in the 1 patient who developed infectious keratitis (sensitivity = 1 and specificity = 0.915). CONCLUSIONS: Few noncomplicated injuries develop infectious keratitis. We recommend fewer follow-ups for these injuries. However, if patients develop any worsening in eye pain, irritation, redness, or decrease in their visual acuity, they should return promptly for reassessment.