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Globe Rupture, Emergency Medicine

Alexander T. Limkakeng, Jr. and Megan G. Kemnitz Reviewed 06/2017
 


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 opposi...

Diagnosis

Signs and Symptoms

  • Pain

  • Localized ecchymosis and swelling

  • Scleral or corneal laceration

  • Extrusion of intraocular contents

  • Markedly decreased visual acuity

  • Limited extraocular motion

  • Hyphema

  • Severe s...

Treatment

Pre-Hospital

  • Place a shield (not patch) over eye with no pressure on the globe.

  • Use a Styrofoam cup if no shield available.

Initial Stabilization/Therapy

  • Keep manipulation of the eye to a minimu...

Follow-Up

Disposition

Admission Criteria

  • All patients with globe rupture/penetrating eye injuries

  • Early enucleation for severe injury

Discharge Criteria

Globe penetration excluded 

Issues for Referral

  • Emerge...

Pearls and Pitfalls

  • Do not manipulate the eye if you suspect or confirm a ruptured globe:

    • Place eye shield over affected eye.

  • Administer antiemetic for patients with nausea and vomiting to prevent eleva...

Additional Reading

  • Linden  JA, Renner  GS.Trauma to the globe. Emerg Med Clin North Am. 1995;13(3):581–605.

  • Marx  JA, Hockberger  RS, Walls  RM, et al. Rosen's Emergency Medicine. 7th ed. Philade...

Codes

ICD9

  • 871.0 Ocular laceration without prolapse of intraocular tissue

  • 871.2 Rupture of eye with partial loss of intraocular tissue

ICD10

  • S05.20XA Oclr lac/rupt w prolaps/loss of intraoc tiss, unsp eye...

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