The CMGs offer information on the diagnosis and management of a range of conditions that present with varying frequency in primary and first contact care.
Sub-tarsal Foreign Body (STFB) is a painful condition in which specks of dust or other debris become embedded in the tarsal conjunctiva. It can cause vertical abrasion tracks on the cornea. Symptoms include acute foreign body sensation, pain, lacrimation and eye reddening. This Clinical Management Guideline outlines the aetiology, signs and symptoms and evidence-based recommendations for diagnosing, managing and treating STFB. It provides recommendations for non-pharmacological management including how to remove foreign bodies, and pharmacological treatment approaches.
What is sub-tarsal foreign body?
A sub-tarsal foreign body occurs when a speck of dust or other debris, landing on the eye, gets trapped under the upper eyelid. While there it may cause discomfort which increases on blinking because the particle rubs against the surface of the eye. Usually, the patient will know that something has blown into the eye.
How is sub-tarsal foreign body managed?
An optometrist will examine the eye gently turning the upper eyelid inside out to look underneath it, and if a foreign body is found, it will usually be removed during the examination. Sometimes a drop of local anaesthetic is needed to reduce the discomfort of this procedure. Generally, no further treatment is needed, but if there is a large abrasion of the surface of the cornea (the clear window at the front of the eye) or any evidence of infection, a course of local antibiotic drops or ointment may be prescribed. These cases rarely need referral to an ophthalmologist (specialist eye doctor).
Sub-tarsal foreign body (STFB) - 5 June 2026 The predisposing factors section has been amended to include occupation and activities that may increase the risk of sub-tarsal foreign body. The signs section now includes detail on the typical corneal staining pattern observed in sub-tarsal foreign body. The non-pharmacological management section has been amended to clearly set out the need to assess the cornea for adherent or embedded material that may also be present in sub-tarsal foreign body.
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