Ruptured globe is characterized by which of the following?

• A. Pain and tearing only
• B. Pain, decreased visual acuity, diplopia, irregular pupils, & orbital leakage
• C. Itching and discharge
• D. Hearing loss

Answer: (B)

A ruptured globe is a full‑thickness break in the eyewall, so the exam findings reflect immediate damage to the eye’s structure and function. Pain is intense because the eye is damaged and irritated. Visual acuity drops sharply as the cornea, lens, retina, and vitreous are disrupted, affecting how well the eye can focus and see. Diplopia arises from disruption of ocular alignment or involvement of the extraocular muscles and surrounding tissues, leading to double vision. Irregular pupils occur when the iris or the sphincter mechanism is damaged or warped by the wound, causing an irregular or abnormal pupil shape. Orbital leakage indicates leakage of intraocular fluids or extrusion of contents through the wound, a direct sign of a globe rupture. These signs together are the telltale combination of this condition. Itching and discharge suggest inflammatory or infectious processes rather than a globe rupture, and hearing loss is unrelated to the ocular injury.