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What is an open globe injury?

An open globe injury (OGI) is where there is a full-thickness break through the outer layers of the eye. It is most commonly due to trauma.

How do you treat an open globe injury?

An OGI is a very serious condition, which can lead to blindness or loss of the eye if untreated. Surgery is usually required to repair normal structures of the eye. Depending on the extent of the damage, multiple surgeries may be needed. Following surgery, eye drops and oral medications are used to treat inflammation, decrease discomfort and reduce the risk of infection.

Are there complications of open globe injuries?

Complications can occur and include eye pain, bleeding, loss of vision, infection, cataract formation, inflammation, scarring, high pressure in the eye and retinal problems. Very rarely, the non-injured eye can become inflamed as a result of the original injury. This condition is called sympathetic ophthalmia and can occur years later. Close follow-up by your eye doctor will be required to monitor recovery and detect early signs of complications.

What is the prognosis?

For the first few weeks, it is often very difficult for doctors to say how severely your vision will be affected. Initial vision and associated injuries are the most important predictors of the outcome. Once any bleeding, swelling or wounds have healed, doctors will be able to give you a more accurate prognosis.

Post-operative instructions

What to expect:
Some discomfort, redness, foreign body sensation and sensitivity to light is normal.

Protecting the eye:

  • Tape a protective plastic shield over the eye at all times for 2 weeks, then only at night for a further 2 weeks.
  • Wear sunglasses outside.

Limited activity:

  • No bending or significant physical activity for at least 2 weeks and potentially up to 6 weeks, depending on the severity of your injury.
  • No driving for 3 months if you have significant loss of vision.

Pain relief:
Use regular paracetamol and check with your eye doctor whether anti-inflammatories can be used (as they may increase risk of bleeding).

General instructions

Eye drops:
The nurses will teach you how to use your drops at home. You can ask them for written instructions. It is very important to take all medications as directed.

Follow-up:
You must attend all of your follow-up appointments. They may be required over a long period of time. Ask your doctor when you can return to work and driving.

Important

  1. Protect both eyes at all times – remember most OGIs are preventable.
  2. Contact your eye doctor or Emergency Department if you experience:
    1. severe eye pain or redness
    2. decreased vision.

Disclaimer This document describes the generally accepted practice at the time of publication only. It is only a summary of clinical knowledge regarding this area. The Royal Victorian Eye and Ear Hospital makes no warranty, express or implied, that the information contained in this document is comprehensive. They accept no responsibility for any consequence arising from inappropriate application of this information.

  • Open Globe Injury – Discharge Instructions #217
  • Owner: Emergency Department
  • Last Reviewed: October 31, 2019
  • Next Review: October 31, 2022