Educational draft · awaiting clinical reviewUse Rapid for revision, not patient-care decisions. Check current national and local guidance and the BNF or BNFC before acting.
2 min synopsisUK scopeSources checked 7 Sept 2026Clinical review pending
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Protect the globe without pressure
A full-thickness corneal or scleral wound can lose intraocular contents when the eye is pressed, rubbed or manipulated.
Action: Stop pressure-producing examination, place a rigid shield with nothing pressing beneath it, leave any embedded object in place and contact ophthalmology immediately; provide systemic analgesia and antiemesis and keep the patient nil by mouth pending surgical planning.
Synopsis
Recognise possible full-thickness eye-wall injury, prevent further extrusion or contamination, and coordinate safe imaging, urgent surgical assessment and perioperative care.
Open globe means a full-thickness wound of the cornea or sclera; blunt rupture and sharp laceration are different mechanisms within this category.
A penetrating injury has an entry wound; a perforating injury has entry and exit wounds, and an intraocular foreign body may remain after penetration.
Use a rigid eye shield, not a pressure pad, and avoid placing gauze against a protruding wound or object.
Key red flags
A peaked pupil, visible uveal prolapse or an ocular wound after high-velocity trauma should be treated as a possible open globe: shield, avoid tonometry and obtain immediate ophthalmology advice.
Investigation priorities
01
Limited acuity and pupillary examinationFirst step
Document visual function without placing pressure on the injured globe.
National guidance is shown before implementation-dependent detail. Typical adult dose examples remain subject to patient factors, contraindications and the live BNF or specialist protocol. Source check completed 7 Sept 2026; clinical approval remains outstanding.