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Globe rupture / Severe eye injury and surgical repair - A State of Sight #103

An extreme eye injury can cause a globe rupture where the eyeball can split open. This can be due to trauma directly on the eye or around the eye.

Watch this episode of A State of Sight with Isaac Porter, MD to learn more about this injury and the eye surgery options to help save the eye and restore vision.



Welcome to A State of Sight. I’m Isaac Porter and this is your update in ophthalmology and eye care from Raleigh.  Today, I would like to explain globe rupture, which is a severe injury to the eye that actually splits open the eyeball.
 
This can happen from extreme trauma to the eye such as a direct hit or an indirect injury like a car collision. When this happens, the white part of the eye, the sclera, can actually split open in some places.
 
We usually see this in a couple of places, typically one can be around the limbus, the edge where the white part of the eye meets the clear cornea. The other common location can be it around or behind where the eye muscles attach to the eyeball. These places can be a little bit weaker than the rest of the eye.
 
When there is a globe rupture, the most important treatment is surgery so we can try and save the eye. This can be a complicated surgery that can be very difficult at times. We attempt to replace any of the tissue from inside the eye that may have come out at the time of the injury (except for lens material). Then we use very fine stitches repair the eyeball and make it watertight again.
 
If you look back to A State of Sight # 48, we explained corneal lacerations, which is a different type of injury where a cut splits open the cornea on the front of the eye. However, many of the same surgical ideas and techniques apply to repairing both corneal lacerations and ruptured globes. Overall, we are first trying to save the eye. Afterwards, other procedures may be necessary to help recover vision in the eye.
 
If the injury causes formation of a cataract, the cataract may be need to be removed later and replaced with a lens implant. Other patients may need retina surgery later to repair the retina or a retinal detachment, or to remove blood or the vitreous gel from the back of the eye.
 
A lot of times when we see a very severe hit to the eye, there may be fractures of the eye socket or the orbital bones around the eye. Sometimes, these fractures can actually be good for the eyeball because they can relieve some of the force of the impact so that the full force does not affect the eye. When there are no orbital fractures, sometimes we see the eye take all of the stress, causing a ruptured globe.

If you have any questions about this type of severe injury or if you would like any more information about globe rupture, please post and we will be happy to answer them. Hopefully see you again soon, next time on A State of Sight.