Back to Basics: Globe Rupture

Globe Rupture

  • Vision threatening emergency
  • Blunt or penetrating trauma that causes a sudden elevation of intraocular pressure
  • Hx ocular surgery or previous ocular injury may predispose
  • When suspected, cover eye with metal or protective eye shield
  • Immediate consult to ophthalmology
  • Do NOT measure intraocular pressure
  • Examine with gentle retraction of eyelids (avoid increase IOP)
  • May have decreased visual acuity; Irregular or teardrop shaped pupil; Afferent pupillary defect; Hyphema; Positive Seidel test (anterior chamber leakage with Fluorescein stain); Lens dislocation; Subconjunctival hemorrhage
  • Elevate HOB
  • Broad spectrum IV abx (ex. IV levofloxacin 500mg q24hr and IV cefazolin 1g q8H)
  • Sedation, Analgesia and Antiemetic if needed to prevent increase IOP
  • Update Tetanus
  • NPO


Walker RA, Adhikari S. "Eye Emergencies." Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, 8eEds. Judith E. Tintinalli, et al. New York, NY: McGraw-Hill, 2016, pg 1568-69.