Globe rupture

A comprehensive overview of globe rupture

Overview

Diagram of the human eye anatomy

Globe rupture is a serious ophthalmic condition characterized by a full-thickness injury to the outer membranes of the eye, including the sclera and cornea. This condition is considered an ocular emergency and requires immediate medical attention to prevent permanent vision loss.

Causes

Globe rupture can occur due to various types of trauma, including blunt or penetrating injuries. Common causes include:

• Blunt trauma: Often results from accidents such as motor vehicle collisions or sports injuries, where a sudden impact causes increased intraocular pressure, leading to rupture.
• Penetrating trauma: Occurs when a sharp object pierces the eye, such as a knife or a piece of glass.
• Surgical complications: Rarely, globe rupture can occur as a complication of eye surgery.

Symptoms

The symptoms of globe rupture can vary depending on the severity and location of the injury but may include:

• Severe eye pain
• Decreased vision or complete vision loss
• Visible deformity of the eye
• Hyphema (blood in the anterior chamber of the eye)
• Vitreous hemorrhage
• Proptosis (protrusion of the eye)

Diagnosis

Diagnosis of globe rupture is primarily clinical, based on the history of trauma and physical examination. Key diagnostic steps include:

• Visual inspection for signs of rupture, such as irregular pupil shape or extrusion of intraocular contents.
• Seidel test: A fluorescein dye test to detect leaking aqueous humor.
• Imaging: CT scan of the orbit is often used to assess the extent of the injury and rule out foreign bodies.

Treatment

Immediate treatment is crucial to preserve vision and prevent complications. Management strategies include:

• Protective eye shield: To prevent further injury.
• Surgical repair: Urgent surgical intervention is required to close the rupture and restore the integrity of the globe.
• Antibiotics: To prevent infection, especially in cases of open globe injuries.
• Tetanus prophylaxis: Administered if indicated.

Prognosis

The prognosis for globe rupture depends on the severity of the injury and the promptness of treatment. Early surgical intervention can significantly improve outcomes, but severe injuries may result in permanent vision loss or enucleation of the eye.

Prevention

Preventive measures include wearing protective eyewear during activities that pose a risk of eye injury, such as sports or working with hazardous materials.

Related pages

• Ocular trauma
• Eye surgery
• Vision loss