Join Brit Long, MD as he discusses open globe injuries with Jess Pelletier, MD, an expert in the field. Topics include categorization of open globe injuries, diagnostic terminology, role of imaging, ultrasound in EM, and managing strategies for improved patient outcomes.
Prompt treatment for open globe injuries is crucial to prevent endophthalmitis and improve prognosis.
Accurate classification of open globe injuries based on anatomical descriptions guides appropriate management.
Deep dives
Understanding Open Globe Injury and Its Significance
Open globe injury, a rare but critical diagnosis in emergency medicine, involves full-thickness damage to the eye resulting from blunt or sharp trauma. With an incidence of two to six cases per hundred thousand population, males aged 10 to 30 account for 80% of cases, often due to work-related accidents without protective eyewear. Delays in definitive care increase the risk of endophthalmitis and worsen the prognosis, highlighting the urgency of prompt treatment.
Differentiating Laceration and Rupture in Open Globe Injury
Open globe injury includes laceration, involving a single entry wound, and rupture, typically caused by blunt trauma at weak points on the eye wall. Zone-based anatomical descriptions categorize the extent of injury, aiding in diagnosis. Subtypes like penetration, perforation, and intraocular foreign bodies indicate the nature of the trauma, emphasizing the need for accurate classification for appropriate management.
Pathophysiology and Diagnostic Evaluation of Open Globe Injury
An open globe injury affects the eye's three layers and chambers, with traumatic forces leading to scleral tearing and potential intraocular content extrusion. Clinical presentations include eye pain, altered visual acuity, and pupil abnormalities, prompting a thorough eye examination for confirmation. Diagnostic tools like the positive sidell test and specific physical exam findings aid in identifying these vision-endangering injuries.