Globe Rupture

Basics

A full-thickness corneal or scleral injury owing to trauma
Blunt trauma/globe rupture:
- Causes an abrupt rise in intraocular pressure diffusely
- Subsequent rupture of the eye either opposite the point of impact or at the weakest points:
  - Extraocular muscle insertion
  - Corneoscleral junction
  - Limbus, where the sclera is thinnest
Penetrating injury/globe laceration:
- Occurs with sharp objects or projectiles injuring the sclera or anterior eye directly
- Most commonly anterior and involving the cornea – the bony orbit protects the globe laterally and posteriorly
- Posterior injury can occur with fracture of the bony orbit or with penetrating eyelid/eyebrow injuries
Prognosis worse with:
- Larger lacerations
- Posterior injuries
- Blunt injury
- Intraocular foreign body, especially if made of organic material
- Vitreous extrusion
- Lens damage
- Hyphema
- Retinal detachment
- Poor visual acuity at presentation
- Afferent pupillary defect
- Increased time to OR

Falls, impact injuries
Sport-related injuries (e.g., elbow, ball impacts, arrows, game controllers, etc.)
Indirect concussive injuries (explosions)
Sharp instrument/stabbing injuries, accidental or intentional
High-velocity projectile injuries (industrial, firearms, BB pellets, blast explosion shrapnel)

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