A 24-month review of globe rupture in a tertiary referral hospital

Abstract

Background: Globe rupture is a full thickness penetration of the ocular wall. It is a sight-threatening injury and requires emergent ophthalmic management. Prognosis for vision is dependent on the nature of the rupture, as well as clinical and intraoperative exam findings.

Aims: To identify the outcomes of globe rupture in the University Hospital Galway, a tertiary ophthalmic surgery referral unit, over a 24-month period.

Methods: A retrospective review in all cases of globe rupture was undertaken. The nature of the injury, vision, and exam findings at presentation, and intraoperative findings were recorded. Outcomes included vision at most recent follow-up, the development of complications, and the need for further surgery.

Results: A total of 12 cases were identified: 9 blunt injuries (assault, mechanical fall, workplace accident, self-inflicted) and 3 due to penetration with a sharp object (glass fragment, hammering). Globe rupture was almost twice as common in males under 40 years of age, compared with all patients over 40. All eyes with perception of light vision or less at presentation developed phthisis. Further surgery was required in a minority of cases.

Conclusions: Globe rupture after a mechanical fall was most common in the over-75 age group. Globe rupture from assault, followed by workplace injury, was the most common injury in young males under 40. In an Irish setting, this represents a change in the aetiology of globe ruptures in young males compared with rates reported 20 years ago when workplace injuries were more common. The preventable nature of these injuries is highlighted.

Keywords: Globe rupture; Ophthalmic trauma.