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

  • Emily HughesEmail author
  • Gerry Fahy
Original Article



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.


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


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.


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.


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.


Globe rupture Ophthalmic trauma 



  1. 1.
    Mulvihill A, Eustace P (2000) The pattern of perforating eye injuries in Ireland. Ir J Med Sci 169(1):47–49CrossRefGoogle Scholar
  2. 2.
    Hassett PD, Kelleher CC (1994) The epidemiology of occupational penetrating eye injuries in Ireland. Occup Med (Lond) 44(4):209–211CrossRefGoogle Scholar
  3. 3.
    Negrel AD, Thylefors B (1998) The global impact of eye injuries. Ophthalmic Epidemiol 5(3):143–169CrossRefGoogle Scholar
  4. 4.
    Munier A, Gunning T, Kenny D, O'Keefe M (1998) Causes of blindness in the adult population of the Republic of Ireland. Br J Ophthalmol 82(6):630–633CrossRefGoogle Scholar
  5. 5.
    Viestenz A, Schrader W, Kuchle M, Walter S, Behrens-Baumann W (2008) Management of a ruptured globe. Ophthalmologe 105(12):1163–1174; quiz 1175. CrossRefGoogle Scholar
  6. 6.
    Koo L, Kapadia MK, Singh RP, Sheridan R, Hatton MP (2005) Gender differences in etiology and outcome of open globe injuries. J Trauma 59(1):175–178CrossRefGoogle Scholar
  7. 7.
    Yucel OE, Demir S, Niyaz L, Sayin O, Gul A, Ariturk N (2016) Clinical characteristics and prognostic factors of scleral rupture due to blunt ocular trauma. Eye (Lond) 30(12):1606–1613. CrossRefGoogle Scholar
  8. 8.
    Jian-Wei L, Zhen-Bo H, Shu-Na W, Yu-Guang Z, Ai-Jun D (2015) The clinical characteristics of alcohol-related ocular rupture. Graefes Arch Clin Exp Ophthalmol 253(8):1307–1311. CrossRefGoogle Scholar
  9. 9.
    Rahman I, Maino A, Devadason D, Leatherbarrow B (2006) Open globe injuries: factors predictive of poor outcome. Eye (Lond) 20(12):1336–1341. CrossRefGoogle Scholar
  10. 10.
    Kuhn F, Maisiak R, Mann L, Mester V, Morris R, Witherspoon CD (2002) The Ocular Trauma Score (OTS). Ophthalmol Clin N Am 15(2):163–165 vi CrossRefGoogle Scholar
  11. 11.
    Shah A, Blackhall K, Ker K, Patel D (2009) Educational interventions for the prevention of eye injuries. Cochrane Database Syst Rev (4):CD006527. doi:
  12. 12.
    Lipscomb HJ (2000) Effectiveness of interventions to prevent work-related eye injuries. Am J Prev Med 18(4 Suppl):27–32CrossRefGoogle Scholar
  13. 13.
    Mancini G, Baldasseroni A, Laffi G, Curti S, Mattioli S, Violante FS (2005) Prevention of work related eye injuries: long term assessment of the effectiveness of a multicomponent intervention among metal workers. Occup Environ Med 62(12):830–835. CrossRefGoogle Scholar
  14. 14.
    Vieira ER, Palmer RC, Chaves PH (2016) Prevention of falls in older people living in the community. BMJ 353:i1419. CrossRefGoogle Scholar
  15. 15.
    Feng K, Hu YT, Ma Z (2011) Prognostic indicators for no light perception after open-globe injury: eye injury vitrectomy study. Am J Ophthalmol 152(4):654–662 e652. CrossRefGoogle Scholar
  16. 16.
    Zhang Y, Zhang MN, Jiang CH, Yao Y, Zhang K (2010) Endophthalmitis following open globe injury. Br J Ophthalmol 94(1):111–114. CrossRefGoogle Scholar
  17. 17.
    Beshay N, Keay L, Dunn H, Kamalden TA, Hoskin AK, Watson SL (2017) The epidemiology of open globe injuries presenting to a tertiary referral eye hospital in Australia. Injury 48(7):1348–1354. CrossRefGoogle Scholar

Copyright information

© Royal Academy of Medicine in Ireland 2019

Authors and Affiliations

  1. 1.Department of OphthalmologyUniversity Hospital GalwayGalway CityIreland

Personalised recommendations