Globe Rupture is a topic covered in the 5-Minute Emergency Consult.

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Basics

Description

  • A full-thickness corneal or scleral injury owing totrauma
  • 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—the bony orbit protects the globe laterally and posteriorly
    • Posterior injury can occur with fracture of the bony orbit or with penetrating injuries of the eyelid or eyebrow.
  • Prognosis worse with:
    • Larger lacerations
    • Injury posterior to the rectus insertion
    • 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

Etiology

  • 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
  • Projectile injuries (industrial, firearms, BB pellets, blast explosion shrapnel—glass, etc.)

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Citation

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TY - ELEC T1 - Globe Rupture ID - 307294 Y1 - 2016 PB - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307294/all/Globe_Rupture ER -