Your eyeball (the globe of your eye) can be seriously injured in fights, falls and in motor vehicle or industrial accidents. If your cornea and sclera are penetrated, you have an open globe injury (globe rupture). You need medical help to save your vision.
Open globe injury (often referred to simply as “an open globe”) is the term for an eyeball injury where trauma has caused a full-thickness cut or defect in the wall of your eye. (This term comes from the fact that medical professionals often call the eyeball “the globe.”) Open globe injuries generally happen because of severe blunt or penetrating trauma to your eye.
Various forms of open globe injury exist:
In all of these cases, a section of the eye wall is no longer intact, potentially allowing eye contents to extrude outside of the eye.
The eye wall has two sections: the sclera and the cornea. The sclera is the white part of your eye. The cornea is the clear front portion. You have an open globe injury when a full-thickness cut goes through either the cornea or the sclera or through both of them.
An open globe injury is different from a corneal abrasion, which is a scratch on the surface of the cornea. Corneal abrasions are much more common and generally less severe than open globe injuries.
An open globe can happen to anyone. However, studies indicate that it’s more common among people assigned male at birth (AMAB). Moreover, it occurs twice as often to people AMAB who are under age 40 than to those who are over 40.
You may be more at risk of an open globe injury if you’ve had previous eye surgery because the protective tissues of the eye may be weaker at certain points. This includes cataract surgeries, glaucoma surgeries and certain forms of corneal transplants.
In the United States, the number of open globe injuries is approximately 3 per 100,000 people.
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The signs and symptoms of open globe injury vary but may include:
Common causes of open globe injuries include:
If you think it’s possible that you have an open globe, it’s critical that you don’t rub or apply any pressure to the eye and that you go to an ophthalmologist or emergency department immediately. An eye care provider may suspect an open globe injury based on your eye’s appearance, your symptoms, certain imaging techniques — like ultrasound or magnetic resonance imaging (MRI) — or your facial injuries.
If it’s possible, a provider will ask you questions about the events and timing of your injury, as well as what happened afterwards. The first examination should put no pressure at all on the eye. A provider will likely do tests, including:
A provider is unlikely to order certain tests until after they determine whether you have an open globe injury. For instance, you shouldn’t have a scan if you have an open globe injury since you may have metal debris in your eye, which would make an MRI potentially dangerous.
Open globe injuries are medical emergencies. If the trauma has caused other life-threatening injuries, then the healthcare team will take care of those first. An ophthalmologist should see open globe injuries as soon as possible.
Most open globe injuries require surgery. While awaiting your surgery, or if your open globe doesn’t need surgery, you should:
Open globe injuries most often require urgent surgical treatment, including sutures to close wounds in your cornea and sclera. If you need surgery, your surgeon may reinsert eye tissue that has come through the wound or remove these tissues if the provider can’t repair the damage. They’ll also try to return your eye to the correct pressure.
After any type of surgery, your provider will prescribe topical antibiotics and possibly oral antibiotics. These antibiotics are to prevent endophthalmitis and other infections.
It usually takes at least two weeks for your eye to heal, but you’ll have to continue protecting it for several weeks after that.
Importantly, the initial surgery for globe rupture is primarily just to close the eye so that it can begin the healing process. Many times, you might have additional injuries (such as retinal detachment, cataract, or iris tears). Providers may treat these injuries with later surgery once the eye has begun to heal from the trauma.
You’ll need several follow-up appointments to check on your progress. Coming to these appointments is critical to the health of your eye.
Open globe injury is one of the most severe injuries an eye can have. The outcomes vary a lot from case to case depending on the nature and extent of the injury.
It’s impossible to prevent all accidents, but some preventative measures can help. Here are some tips that may help prevent open globe injuries:
If you have an open globe injury, it’s usually best to have surgery within 24 to 48 hours of the injury. Recovery will also depend on how severe the initial injury is.
An injury to your eye is a medical emergency. You need to see a healthcare provider or go to an emergency room right away.
If you do have an open globe injury, you may want to ask your ophthalmologist:
A note from Cleveland Clinic
If you injure your eye in any kind of fight, fall or accident, go immediately to an emergency room. It may not be evident to you right away if you have an open globe injury, but if you do, you may need medical help right away to preserve vision or even save your eye. There’s help available for this condition. You can also help yourself by taking measures to prevent a globe rupture from happening by always wearing recommended eye protection and using safe driving practices.
Last reviewed by a Cleveland Clinic medical professional on 12/11/2022.
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