A giant subconjunctival foreign body in the lacrimal region: A case report

A giant subconjunctival foreign body in the lacrimal region: A case report | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Case Report A giant subconjunctival foreign body in the lacrimal region: A case report Jiao Zhao, Zhike Xu, Qingqing Zhang This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6942287/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 03 Nov, 2025 Read the published version in BMC Ophthalmology → Version 1 posted 16 You are reading this latest preprint version Abstract Background Foreign bodies are a common cause of eye pain and tears. Here, we report a case of a large vegetable foreign body that penetrated the conjunctiva into the subconjunctival lacrimal caruncle as a result of vigorous eye rubbing. Case presentation: A 50-year-old woman from rural Leshan presented with persistent redness and swelling at the inner canthus of her left eye for 10 days. The conjunctiva overlying the lacrimal caruncle appeared elevated, congested, and edematous. A sharp, approximately 1-mm foreign body of vegetable origin was visible on the nasal aspect of the elevated area. The temporal bulbar conjunctiva appeared pale and semicircular. The extracted plant foreign body resembled a seed, measuring 8 mm in length and 4 mm in diameter, with surface burrs. Following removal, the patient's symptoms resolved. Conclusion When evaluating patients presenting with chief complaints of ocular irritation, thorough ocular examinations should be performed with particular attention to ruling out occult foreign bodies. Concurrently, it is imperative to strengthen ophthalmic health education initiatives, prioritizing standardized trauma management protocols to prevent secondary ocular damage resulting from suboptimal first-aid interventions. Foreign bodies eye pain eye rubbing Figures Figure 1 Figure 2 Background Foreign bodies are a common cause of eye pain and tears. Small foreign bodies may attach to the cornea or become sequestered in the conjunctiva of the upper or lower eyelids, whereas larger foreign bodies can cause severe pain. Patients with foreign bodies in their eyes often rub the region forcefully in an attempt to relieve discomfort or expel the foreign object. In this report, we present a case of a large vegetable foreign body that penetrated the conjunctiva into the subconjunctival lacrimal caruncle as a result of vigorous eye rubbing. Case presentation A 50-year-old woman from rural Leshan presented with persistent redness and swelling at the inner canthus of her left eye for 10 days. She had initially consulted a local hospital, where she was diagnosed with conjunctivitis and prescribed levofloxacin eye drops. However, her symptoms persisted, prompting referral to our institution. Ophthalmic examination revealed the following: uncorrected visual acuity was 1.0 in both eyes; intraocular pressure was 14 mmHg in the right eye and 15 mmHg in the left eye. The bulbar conjunctiva at the inner canthus of the left eye was congested. The conjunctiva overlying the lacrimal caruncle appeared elevated, congested, and edematous. A sharp, approximately 1-mm foreign body of vegetable origin was visible on the nasal aspect of the elevated area. The temporal bulbar conjunctiva appeared pale and semicircular (Fig. 1 ). The cornea was transparent; anterior chamber depth was normal; the pupils were round with normal light reflexes; the lens was clear; and fundus examination revealed no abnormalities. Based on these findings, the patient was diagnosed with a subconjunctival foreign body at the left lacrimal caruncle and secondary conjunctivitis. Under topical anesthesia with procaine hydrochloride, the plant foreign body (measuring 8 mm in length and 4 mm in diameter) was extracted. The foreign body was oblong with surface burrs, resembling a plant seed (Fig. 2 ). Upon further history-taking, the patient recalled that the ocular pain initially began while farming. She experienced a foreign body sensation and had rubbed her eye vigorously in response. Following extraction, the patient's wound healed uneventfully. Discussion and Conclusions Ocular foreign bodies are commonly encountered in ophthalmology practice. Generally, larger objects entering the eye are expelled by natural defense mechanisms, whereas smaller objects such as eyelashes and insect debris may adhere to the cornea or conjunctiva or become lodged in the fornices, causing discomfort, lacrimation, and pain [ 1 – 6 ]. In the present case, the foreign body at the inner canthus had completely penetrated into the subconjunctival space. Once embedded, the patient's acute symptoms subsided, likely contributing to the initial misdiagnosis as simple conjunctivitis. However, ongoing mechanical stimulation from the foreign body induced localized inflammation and granuloma formation. The clinical manifestations of ocular foreign bodies vary according to their location. Superficial conjunctival foreign bodies typically cause ocular pain, lacrimation, and photophobia. In contrast, large, deeply embedded objects may result in inflammation, ulceration, or perforation, posing substantial risks to visual function and ocular integrity [ 3 – 6 ]. Patients with suspected ocular foreign bodies should avoid eye rubbing to prevent further damage and should seek immediate medical attention. When prompt medical care is unavailable, the following self-care measures may be considered after determining the foreign body location: 1) If the cornea is uninjured, the patient should gently close the eye and allow natural lacrimation to facilitate expulsion. 2) If unsuccessful, the patient may immerse the face in clean water and blink gently several times. 3) If the foreign body persists, an assistant can carefully evert the eyelids and remove the object using a moistened cotton swab. However, suspected corneal foreign bodies require professional medical evaluation [ 7 ]. Leshan City, located in the transitional zone between the Sichuan Basin and the southwestern mountainous region, encompasses diverse terrain, including mountains, hills, and plains. The predominantly mountainous geography creates challenges for healthcare resource distribution, particularly in rural and remote areas. Due to limited health education access, residents in these regions often lack appropriate knowledge for managing medical emergencies. Therefore, strengthening rural healthcare infrastructure and enhancing public health education are essential. Such initiatives can improve health literacy and self-care capabilities among residents, ultimately elevating the regional standard of medical care. When ophthalmologists evaluate patients presenting with chief complaints of ocular irritation, thorough ocular examinations should be performed with particular attention to ruling out occult foreign bodies in the conjunctival sac. Concurrently, it is imperative to strengthen ophthalmic health education initiatives, prioritizing standardized trauma management protocols to prevent secondary ocular damage resulting from suboptimal first-aid interventions. Declarations Ethics approval and consent to participate This case study was approved by the Ethics of Committee of The People’s Hospital of Leshan. Consent for publication Written informed consent for their personal and clinical details along with any identifying images to be published in this study has been obtained from the patient. Availability of data and materials All data generated or analysed during this study are included in this published article. Competing interests The authors declare that they have no competing interests. Funding This study was funded by Science and Technology Project of Leshan (NO. 23SZD013). Authors' contributions JZ drafted this manuscript, collected the data, and reviewed the literature. QZ collected the data. ZX critically reviewed the manuscript. All authors have read and approved the final manuscript . Acknowledgements We would like to thank Editage (www.editage.cn) for English language editing. Authors' information 1 Departments of Ophthalmology, The People’s Hospital of Leshan, Leshan Ophthalmic Center, 639 Hui’an Road, Shizhong District, Leshan, Sichuan 614000, People’s Republic of China. References Xu LJ, Li XY, Wang etal. Clinical characteristics analysis of ocular surface injury caused by occult foreign bodies. Chin J Eye Trauma Occup Ocular Dis. 2023;45(2):107–12. Wang TY. A study of clinical features and histopathologic features of conjunctival granuloma caused by foreign body. Wenzhou Med Univ. 2014;28(15):19–24. Gao L, Lin YL. Misdiagnosis analysis of residual eyelid foreign bodies. Chin J Traditional Chin Ophthalmol. 2006;(1): 62. Gao DX. A case report of huge plant foreign body in the eyelid and bulbar conjunctiva. J Jiangxi Univ Traditional Chin Med. 1998;10(1):13–4. Mu XL, Li ZL. Clinical analysis of 45 cases of fornix conjunctival foreign body caused by wheat awn. Chin J Compr Med. 2012;(8): 751–2. Cheng J, Dong YL, Zhai HL. etal. Clinical observation of ocular injury caused by chestnut burr. Chin J Ophthalmol. 2020;56(5):370–5. Zhang WL, Wang XL. Management measures for extraocular foreign bodies. Chin J Practical Rural Doctors. 2008;15(6):15. Wang YL, Hu QF, Liu RF, et al. Equity analysis of health resource allocation in Sichuan and Chongqing. Health Soft Sci. 2024;38(1):58–63. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 03 Nov, 2025 Read the published version in BMC Ophthalmology → Version 1 posted Editorial decision: Revision requested 10 Jul, 2025 Reviews received at journal 09 Jul, 2025 Reviews received at journal 03 Jul, 2025 Reviews received at journal 02 Jul, 2025 Reviews received at journal 01 Jul, 2025 Reviewers agreed at journal 30 Jun, 2025 Reviewers agreed at journal 30 Jun, 2025 Reviewers agreed at journal 30 Jun, 2025 Reviewers agreed at journal 30 Jun, 2025 Reviewers agreed at journal 29 Jun, 2025 Reviewers agreed at journal 29 Jun, 2025 Reviewers invited by journal 29 Jun, 2025 Editor assigned by journal 29 Jun, 2025 Editor invited by journal 25 Jun, 2025 Submission checks completed at journal 24 Jun, 2025 First submitted to journal 24 Jun, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6942287","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Case Report","associatedPublications":[],"authors":[{"id":479110609,"identity":"039f7569-9fa9-4004-93c7-4df3359f1e89","order_by":0,"name":"Jiao Zhao","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAzUlEQVRIiWNgGAWjYBACfvnnx38k/LCRs29vIFKLZENOgsTHnjRjA54DRGoxOJBgIDmD7XDiBokEYl124ECCMQ8PM+N2yccbbzDU2EQT1MHY2HggmceCjdlydlqxBcOxtNwGQlqYmRkSDvPw8LAx3M4xk2BsOExYCxsbg2EzD5sED8PNM0Rq4eFhMGacwWYgYXCDh0gtEhI8aQwfe4DB1gP0SwIxfrG/wX6MIeHH//p+9sMbb3yosSGsBRkYEB81CC2k6hgFo2AUjIKRAQCyqTzFi3ccUAAAAABJRU5ErkJggg==","orcid":"","institution":"The People’s Hospital of Leshan, Leshan Ophthalmic Center","correspondingAuthor":true,"prefix":"","firstName":"Jiao","middleName":"","lastName":"Zhao","suffix":""},{"id":479110610,"identity":"829ce985-3471-442b-a9e8-64346daff5a8","order_by":1,"name":"Zhike Xu","email":"","orcid":"","institution":"The People’s Hospital of Leshan, Leshan Ophthalmic Center","correspondingAuthor":false,"prefix":"","firstName":"Zhike","middleName":"","lastName":"Xu","suffix":""},{"id":479110611,"identity":"7dcd86c3-686f-4dd1-8e43-cde395dcafbb","order_by":2,"name":"Qingqing Zhang","email":"","orcid":"","institution":"The People’s Hospital of Leshan, Leshan Ophthalmic Center","correspondingAuthor":false,"prefix":"","firstName":"Qingqing","middleName":"","lastName":"Zhang","suffix":""}],"badges":[],"createdAt":"2025-06-21 03:08:07","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6942287/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6942287/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12886-025-04386-0","type":"published","date":"2025-11-03T15:56:50+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":85911388,"identity":"c246acd4-7e43-43e9-ac1c-f81c34b9a0a1","added_by":"auto","created_at":"2025-07-03 05:38:06","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":31316,"visible":true,"origin":"","legend":"\u003cp\u003eThe conjunctiva in the lacrimal caruncle area appeared raised, congested, and edematous. A sharp, approximately 1 mm-long foreign body of vegetable origin was visible on the nasal side of the raised area. The temporal bulbar conjunctiva was pale and semicircular.\u003c/p\u003e","description":"","filename":"Figure1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-6942287/v1/f64ac9fd6439ef8be0ec3752.jpg"},{"id":85911892,"identity":"e3b8e600-a3ea-466b-89be-c42f4e0e66c3","added_by":"auto","created_at":"2025-07-03 05:46:06","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":23043,"visible":true,"origin":"","legend":"\u003cp\u003eThe plant foreign body was 8 mm in length and 4 mm in diameter. It was oblong, with burrs on its surface, and resembled a plant seed.\u003c/p\u003e","description":"","filename":"Figure2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-6942287/v1/d5621f8bd9a4d35d70b06acd.jpg"},{"id":95563846,"identity":"cd2c2035-1ebe-4e19-a87b-efa4aba94ecf","added_by":"auto","created_at":"2025-11-10 15:58:51","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":381102,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6942287/v1/4040a0ce-279a-4fc6-8c28-51300195233b.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"A giant subconjunctival foreign body in the lacrimal region: A case report","fulltext":[{"header":"Background","content":"\u003cp\u003eForeign bodies are a common cause of eye pain and tears. Small foreign bodies may attach to the cornea or become sequestered in the conjunctiva of the upper or lower eyelids, whereas larger foreign bodies can cause severe pain. Patients with foreign bodies in their eyes often rub the region forcefully in an attempt to relieve discomfort or expel the foreign object. In this report, we present a case of a large vegetable foreign body that penetrated the conjunctiva into the subconjunctival lacrimal caruncle as a result of vigorous eye rubbing.\u003c/p\u003e"},{"header":"Case presentation","content":"\u003cp\u003eA 50-year-old woman from rural Leshan presented with persistent redness and swelling at the inner canthus of her left eye for 10 days. She had initially consulted a local hospital, where she was diagnosed with conjunctivitis and prescribed levofloxacin eye drops. However, her symptoms persisted, prompting referral to our institution. Ophthalmic examination revealed the following: uncorrected visual acuity was 1.0 in both eyes; intraocular pressure was 14 mmHg in the right eye and 15 mmHg in the left eye. The bulbar conjunctiva at the inner canthus of the left eye was congested. The conjunctiva overlying the lacrimal caruncle appeared elevated, congested, and edematous. A sharp, approximately 1-mm foreign body of vegetable origin was visible on the nasal aspect of the elevated area. The temporal bulbar conjunctiva appeared pale and semicircular (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). The cornea was transparent; anterior chamber depth was normal; the pupils were round with normal light reflexes; the lens was clear; and fundus examination revealed no abnormalities.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eBased on these findings, the patient was diagnosed with a subconjunctival foreign body at the left lacrimal caruncle and secondary conjunctivitis. Under topical anesthesia with procaine hydrochloride, the plant foreign body (measuring 8 mm in length and 4 mm in diameter) was extracted. The foreign body was oblong with surface burrs, resembling a plant seed (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). Upon further history-taking, the patient recalled that the ocular pain initially began while farming. She experienced a foreign body sensation and had rubbed her eye vigorously in response. Following extraction, the patient's wound healed uneventfully.\u003c/p\u003e "},{"header":"Discussion and Conclusions","content":"\u003cp\u003eOcular foreign bodies are commonly encountered in ophthalmology practice. Generally, larger objects entering the eye are expelled by natural defense mechanisms, whereas smaller objects such as eyelashes and insect debris may adhere to the cornea or conjunctiva or become lodged in the fornices, causing discomfort, lacrimation, and pain [\u003cspan additionalcitationids=\"CR2 CR3 CR4 CR5\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. In the present case, the foreign body at the inner canthus had completely penetrated into the subconjunctival space. Once embedded, the patient's acute symptoms subsided, likely contributing to the initial misdiagnosis as simple conjunctivitis. However, ongoing mechanical stimulation from the foreign body induced localized inflammation and granuloma formation.\u003c/p\u003e \u003cp\u003eThe clinical manifestations of ocular foreign bodies vary according to their location. Superficial conjunctival foreign bodies typically cause ocular pain, lacrimation, and photophobia. In contrast, large, deeply embedded objects may result in inflammation, ulceration, or perforation, posing substantial risks to visual function and ocular integrity [\u003cspan additionalcitationids=\"CR4 CR5\" citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Patients with suspected ocular foreign bodies should avoid eye rubbing to prevent further damage and should seek immediate medical attention. When prompt medical care is unavailable, the following self-care measures may be considered after determining the foreign body location: 1) If the cornea is uninjured, the patient should gently close the eye and allow natural lacrimation to facilitate expulsion. 2) If unsuccessful, the patient may immerse the face in clean water and blink gently several times. 3) If the foreign body persists, an assistant can carefully evert the eyelids and remove the object using a moistened cotton swab. However, suspected corneal foreign bodies require professional medical evaluation [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eLeshan City, located in the transitional zone between the Sichuan Basin and the southwestern mountainous region, encompasses diverse terrain, including mountains, hills, and plains. The predominantly mountainous geography creates challenges for healthcare resource distribution, particularly in rural and remote areas. Due to limited health education access, residents in these regions often lack appropriate knowledge for managing medical emergencies. Therefore, strengthening rural healthcare infrastructure and enhancing public health education are essential. Such initiatives can improve health literacy and self-care capabilities among residents, ultimately elevating the regional standard of medical care.\u003c/p\u003e \u003cp\u003eWhen ophthalmologists evaluate patients presenting with chief complaints of ocular irritation, thorough ocular examinations should be performed with particular attention to ruling out occult foreign bodies in the conjunctival sac. Concurrently, it is imperative to strengthen ophthalmic health education initiatives, prioritizing standardized trauma management protocols to prevent secondary ocular damage resulting from suboptimal first-aid interventions.\u003c/p\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis case study was approved by the Ethics of Committee of The People’s Hospital of Leshan.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWritten informed consent for their personal and clinical details along with any identifying images to be published in this study has been obtained from the patient.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll data generated or analysed during this study are included in this published article.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was funded by Science and Technology Project of Leshan (NO. 23SZD013).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors' contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eJZ drafted this manuscript, collected the data, and reviewed the literature. QZ collected the data. ZX critically reviewed the manuscript. All authors have read and approved the final manuscript .\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe would like to thank Editage (www.editage.cn) for English language editing. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors' information\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e1\u003c/sup\u003eDepartments\u0026nbsp;of Ophthalmology,\u0026nbsp;The\u0026nbsp;People’s Hospital of Leshan, Leshan Ophthalmic Center, 639\u0026nbsp;Hui’an Road, Shizhong District, Leshan,\u0026nbsp;Sichuan\u0026nbsp;614000,\u0026nbsp;People’s Republic of\u0026nbsp;China.\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eXu LJ, Li XY, Wang etal. Clinical characteristics analysis of ocular surface injury caused by occult foreign bodies. Chin J Eye Trauma Occup Ocular Dis. 2023;45(2):107\u0026ndash;12.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWang TY. A study of clinical features and histopathologic features of conjunctival granuloma caused by foreign body. Wenzhou Med Univ. 2014;28(15):19\u0026ndash;24.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGao L, Lin YL. Misdiagnosis analysis of residual eyelid foreign bodies. Chin J Traditional Chin Ophthalmol. 2006;(1): 62.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGao DX. A case report of huge plant foreign body in the eyelid and bulbar conjunctiva. J Jiangxi Univ Traditional Chin Med. 1998;10(1):13\u0026ndash;4.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMu XL, Li ZL. Clinical analysis of 45 cases of fornix conjunctival foreign body caused by wheat awn. Chin J Compr Med. 2012;(8): 751\u0026ndash;2.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCheng J, Dong YL, Zhai HL. etal. Clinical observation of ocular injury caused by chestnut burr. Chin J Ophthalmol. 2020;56(5):370\u0026ndash;5.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZhang WL, Wang XL. Management measures for extraocular foreign bodies. Chin J Practical Rural Doctors. 2008;15(6):15.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWang YL, Hu QF, Liu RF, et al. Equity analysis of health resource allocation in Sichuan and Chongqing. Health Soft Sci. 2024;38(1):58\u0026ndash;63.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-ophthalmology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"boph","sideBox":"Learn more about [BMC Ophthalmology](http://bmcophthalmol.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/boph","title":"BMC Ophthalmology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Foreign bodies, eye pain, eye rubbing","lastPublishedDoi":"10.21203/rs.3.rs-6942287/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6942287/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eForeign bodies are a common cause of eye pain and tears. Here, we report a case of a large vegetable foreign body that penetrated the conjunctiva into the subconjunctival lacrimal caruncle as a result of vigorous eye rubbing.\u003c/p\u003e\u003ch2\u003eCase presentation:\u003c/h2\u003e \u003cp\u003eA 50-year-old woman from rural Leshan presented with persistent redness and swelling at the inner canthus of her left eye for 10 days. The conjunctiva overlying the lacrimal caruncle appeared elevated, congested, and edematous. A sharp, approximately 1-mm foreign body of vegetable origin was visible on the nasal aspect of the elevated area. The temporal bulbar conjunctiva appeared pale and semicircular. The extracted plant foreign body resembled a seed, measuring 8 mm in length and 4 mm in diameter, with surface burrs. Following removal, the patient's symptoms resolved.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eWhen evaluating patients presenting with chief complaints of ocular irritation, thorough ocular examinations should be performed with particular attention to ruling out occult foreign bodies. Concurrently, it is imperative to strengthen ophthalmic health education initiatives, prioritizing standardized trauma management protocols to prevent secondary ocular damage resulting from suboptimal first-aid interventions.\u003c/p\u003e","manuscriptTitle":"A giant subconjunctival foreign body in the lacrimal region: A case report","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-07-03 05:14:01","doi":"10.21203/rs.3.rs-6942287/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-07-10T07:45:59+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-07-09T06:31:41+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-07-03T08:12:37+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-07-02T05:47:32+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-07-01T13:52:49+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"204956039451935134606330652019047329414","date":"2025-06-30T20:01:00+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"292665243887913326402393137119316639762","date":"2025-06-30T14:07:10+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"14893764231323078244671927219399999278","date":"2025-06-30T12:43:47+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"155180200192227827041004150138320828924","date":"2025-06-30T04:26:37+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"334926674513643584113165063665349826385","date":"2025-06-29T20:18:49+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"111419801828809579457797216251141715638","date":"2025-06-29T19:05:35+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-06-29T18:19:52+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-06-29T18:00:18+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-06-25T04:48:03+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-06-24T14:47:23+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Ophthalmology","date":"2025-06-24T14:44:53+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-ophthalmology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"boph","sideBox":"Learn more about [BMC Ophthalmology](http://bmcophthalmol.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/boph","title":"BMC Ophthalmology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"2f5f81b3-eab9-4db2-baac-3389a46f8ae7","owner":[],"postedDate":"July 3rd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-11-10T15:58:22+00:00","versionOfRecord":{"articleIdentity":"rs-6942287","link":"https://doi.org/10.1186/s12886-025-04386-0","journal":{"identity":"bmc-ophthalmology","isVorOnly":false,"title":"BMC Ophthalmology"},"publishedOn":"2025-11-03 15:56:50","publishedOnDateReadable":"November 3rd, 2025"},"versionCreatedAt":"2025-07-03 05:14:01","video":"","vorDoi":"10.1186/s12886-025-04386-0","vorDoiUrl":"https://doi.org/10.1186/s12886-025-04386-0","workflowStages":[]},"version":"v1","identity":"rs-6942287","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6942287","identity":"rs-6942287","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}