Occult globe rupture: diagnostic and treatment challenge

Area of Science:

• Ophthalmology
• Trauma Surgery

Background:

• Occult globe rupture involves scleral dehiscence posterior to rectus muscles, often missed on initial examination.
• This condition poses diagnostic challenges and risks ocular content herniation if not managed promptly.

Purpose of the Study:

• To highlight the diagnostic signs and management principles for occult globe rupture.
• To emphasize the importance of early surgical intervention for preserving vision.

Main Methods:

• Clinical diagnosis based on history of severe ocular trauma and slit-lamp examination.
• Anterior chamber depth, iris retraction, chemosis, hypotony, and vitreous hemorrhage are key indicators.
• Imaging studies like CT and ultrasonography aid diagnosis when slit-lamp exam is limited.

Main Results:

• A deep anterior chamber with retracted iris is pathognomonic for posterior globe dehiscence.
• Hemorrhagic chemosis, hypotony, and vitreous hemorrhage are significant supporting signs.
• Surgical exploration is recommended upon strong suspicion of occult rupture.

Conclusions:

• Prompt diagnosis and surgical repair are essential for managing occult globe rupture.
• Subsequent vitreoretinal surgery may be necessary for complications like retinal detachment.
• Special precautions are advised during pars plana vitrectomy if globe closure is compromised.