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Removal of foreign body, external eye; conjunctival embedded (includes concretions), subconjunctival, or scleral nonperforating

CPT4 code

Name of the Procedure:

Removal of foreign body, external eye; conjunctival embedded (includes concretions), subconjunctival, or scleral nonperforating

Common name(s): Foreign body removal from the eye

Summary

This procedure involves the removal of any object that is stuck in the outer parts of the eye, specifically in the conjunctiva (the membrane covering the white part of the eye and the inside of the eyelids), the subconjunctiva (space beneath this membrane), or the sclera (the white part of the eye). It often includes the removal of conjunctival concretions (small calcium deposits).

Purpose

The procedure addresses the presence of foreign bodies in the eye to prevent infection, inflammation, and other potential complications. The goal is to restore comfort, protect the eye's health, and maintain vision quality.

Indications

  • Symptoms such as severe eye discomfort, pain, redness, or excessive tearing.
  • Visible foreign object in the eye.
  • Sensation of something being in the eye even if not visible.
  • Risk of infection or inflammation due to the foreign body.

Preparation

  • No specific fasting required.
  • Patients should avoid rubbing the eye.
  • An initial eye examination and possibly imaging tests to locate the foreign body.
  • Dilating drops might be used for better visualization.

Procedure Description

  1. The patient's eye is numbed using local anesthetic drops.
  2. The eye is examined under a specialized microscope.
  3. Small surgical instruments, such as fine forceps or needles, are used to carefully remove the foreign body.
  4. If concretions are present, they are gently removed.
  5. The area is flushed with saline solution to cleanse the eye.

Duration

Typically, the procedure takes about 15-30 minutes, depending on the complexity.

Setting

The procedure is typically performed in an outpatient clinic or an ophthalmologist’s office.

Personnel

  • Ophthalmologist or trained eye care specialist.
  • Medical assistant or nurse for support and patient preparation.

Risks and Complications

  • Temporary discomfort or irritation.
  • Minor bleeding.
  • Risk of infection.
  • Potential for incomplete removal, requiring a second procedure.
  • Rare risk of damage to the eye tissue.

Benefits

  • Immediate relief from discomfort and pain.
  • Prevention of infection and further complications.
  • Restoration and preservation of vision.

Recovery

  • Patients may need to use antibiotic eye drops or ointment to prevent infection.
  • Avoid touching or rubbing the eye.
  • Wear protective eyewear if advised.
  • Follow-up appointment may be required to ensure proper healing.
  • Normal activities can usually be resumed almost immediately, though strenuous activities should be avoided for a few days.

Alternatives

  • Observation and lubrication with eye drops if the foreign body is very small and non-threatening.
  • Referral to an ophthalmologist if it cannot be safely removed in a regular clinic setting.
  • In very mild cases, the body might naturally expel the foreign body over time.

Patient Experience

  • Brief sensation of pressure or discomfort during the numbing process.
  • Possible fleeting discomfort during removal, though generally pain is minimal due to anesthetics.
  • Following the procedure, eyes may feel slightly irritated or gritty, but this should resolve quickly.

Pain management includes the use of anesthetic drops during the procedure and over-the-counter pain relief medications afterward if needed.

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