Cornea and External Diseases

Corneal Laceration

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.