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Cornea & External Diseases

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Trauma
Rupture Globe

  • Corneal laceration may result from trauma which ranges from nonperforating trauma to full thickness lacerations (rupture globe) that may involve intraocular structures.
  • Management:
    • In a nonperforating laceration, descemet's membrane perforation has to be ruled out. It is especially important to observe the integrity of the anterior chamber.
    • Bandage soft contact lens may be sufficient for a small self-sealing, beveled or edematous coneal laceration to protect the wound as it heals.
    • Cyanoacrylate tissue adhesive may be indicated for treatment of small perforating wounds with poor central apposition or stellate lacerations that do not self-seal along with bandage contact lens.
    • Full thickness lacerations (rupture globe) greater than 2-3 mm require suturing to structurally restore the globe's integrity.
    • General anesthesia is indicated particularly if the lacerations are large with possible expulsion of intraocular contents
    • Extensive lacerations with avulsion and large amount of tissue loss may eventually require lamellar or penetrating keratoplasty.
    • Peripheral iridotomy should be done in lacerations extending to the limbus to prevent the formation of anterior synechiae.
    • In corneal lacerations complicated with iris prolapsed, the iris viability should be evaluated for possible repositioning.


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