Globe rupture

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 visualized 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

While obvious globe rupture is a contraindication to ocular ultrasonography, less obvious cases may be incidentally detected with ultrasonography after ocular trauma. Findings consistent with globe rupture include 5:

  • decreased anterior chamber (AC) depth (and/or collapse)
    • anterior chamber may also contain layering, homogenous echogenic debris consistent with hyphema
  • decreased globe volume
    • with loss of spherical contour
  • posterior scleral buckling
    • associated with vitreous hemorrhage
  • intraocular or periocular air
    • scattered echogenicities with "dirty" acoustic shadowing
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Article information

rID: 15812
Synonyms or Alternate Spellings:
  • Ocular globe rupture
  • Rupture of globe
  • Rupture of the globe
  • Ruptured globe

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