Predictors of occult scleral rupture

Abstract

Purpose: To determine which signs are sensitive and specific in the setting of trauma to establish the diagnosis of an occult scleral rupture.

Methods: The charts of patients with presumed scleral rupture were identified retrospectively. The ocular findings among the patients who had a rupture based on findings at surgery were compared with those patients who were noted to have normal findings at surgery.

Results: Visual acuity worse than 20/400, decreased intraocular pressure, intraocular pressure less than that in the nontraumatized eye, and an afferent pupillary defect were all significant indicators of an open globe.

Conclusion: Determining the likelihood of an occult rupture can be facilitated by noting the presence or absence of those indicators that are significant and carry a high specificity.