Curriculum · ENT, Ophthalmology, and Dermatology
Closed globe injury
What it is
Closed globe injury is a form of ocular trauma. It is more serious as any of the ocular structures can get injured. The wall of the globe is intact, and the injury is internal: hyphema, retinal tear or lens dislocation.
Blunt force is drawn in three steps: the ball hits the front of the eye, the globe goes flat from front to back and wide at the sides, and then it returns to shape. The vascular injury site is marked at the front of the eye.
How it is treated
Examine carefully: VA, and IOP if it is safe to take it. Shield the eye if the injury is serious, and treat the specific complication. Cycloplegics are used for hyphema, and NSAIDs are not given. There is no need for TT or IV antibiotics.
The contrast with open globe injury is the point of the pair: there the eye is shielded, the patient is kept NPO, IV antibiotics are given and surgery is urgent, and IOP is never measured and no pressure is applied.