Globe rupture is an ophthalmologic emergency. A ruptured globe or an open-globe injury must be assessed in any patient who has suffered orbital trauma because open-globe injuries are a major cause of blindness.
In a blunt trauma, ruptures are most common at the insertions of the intraocular muscles where the sclera is thinnest.
If intraocular contents are visualised at clinical examination, a diagnosis of a ruptured globe can be obvious.
Globe rupture is traumatic in the vast majority of cases:
- penetrating trauma
- blunt trauma
- chemical e.g. strong acids, alkalis
Rarely atraumatic spontaneous rupture is seen, e.g. patients with coexisting severe glaucoma and scleromalacia perforans.
CT findings that can be present in a globe rupture include 1:
- collapsed globe ("flat tyre" or "mushroom" appearance)
- presence of intraocular gas or a foreign body
- thick posterior sclera
- hazy outline of the globe
- enlarged anterior chamber
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