Open Globe Injury / Intraocular Foreign Body

Overview

A full-thickness wound of the cornea or sclera, with or without a retained intraocular foreign body (IOFB). The mechanism carries suspicion: any high-velocity event — hammering metal on metal, grinding, drilling, power tools — supports managing the eye as an open globe until ophthalmic assessment and appropriate imaging have excluded occult penetration, because a small self-sealing entry wound can leave a comfortable, white, 6/6 eye. The immediate priorities are to protect the globe from any pressure, withhold drops and ointment, keep the patient fasted, control vomiting, and arrange same-day transfer to an ophthalmic surgical unit. CT orbit, at the receiving hospital, is the imaging of choice for suspected IOFB — requested with the referral, never a reason to delay transfer. MRI is never used when a metallic IOFB is possible.