A client presents to the emergency department with a metallic foreign body in the right eye after working with metal grinding equipment without protective eyewear. Which nursing intervention should be the priority?

• Do not touch, irrigate, or apply pressure to the eye. Any manipulation risks extrusion of intraocular contents.
• Stabilize the object. If a large protruding object is present, it should be stabilized, not removed, using a rigid eye shield or paper cup.
• Apply bilateral eye patching. Cover both eyes with sterile gauze or a rigid shield to eliminate consensual eye movement, which can cause the foreign body to lacerate internal structures.
• Immobilize the head. Use sandbags or manual stabilization to restrict head movement and prevent jarring during transport.
• Maintain NPO status and elevate the head of the bed to 30 degrees if no spinal injury is suspected.

High-velocity metal fragments from grinding, hammering, or machining carry a high index of suspicion for intraocular foreign body (IOFB). A seemingly small entry wound on the cornea or sclera can mask severe posterior segment damage. Assume globe penetration until ruled out by CT scan or comprehensive ophthalmic examination.

• Eye irrigation: Contraindicated in suspected penetrating trauma due to risk of disrupting the wound and introducing pathogens.
• Topical anesthetics: May be deferred to the ophthalmologist; repeated instillation can delay epithelial healing and mask pain that signals worsening condition.
• Foreign body removal: Only performed by an ophthalmologist under slit-lamp or surgical microscope guidance.

1. Rapid triage and visual acuity assessment (if possible without manipulating the eye).
2. Bilateral eye shielding and head immobilization.
3. Administer tetanus prophylaxis as indicated.
4. Obtain emergent ophthalmology consultation for surgical evaluation and possible vitrectomy or foreign body extraction.