Which sign would most strongly suggest an open globe injury?

Which sign would most strongly suggest an open globe injury?

• A. Hyphema
• B. Positive Seidel test
• C. Normal pupil
• D. Clear cornea

Answer: (B)

Open globe injury means the eye’s outer wall has a full-thickness breach, allowing intraocular fluid to escape. The Seidel test directly demonstrates this leakage: after applying fluorescein dye, a positive result shows a stream or jet of diluted dye leaking from the wound under cobalt blue light, indicating aqueous humor is escaping through a corneal or scleral rupture. This finding is highly specific for globe rupture and thus the strongest clue that an open globe injury is present. Hyphema can occur with trauma but doesn’t prove the globe is ruptured, and a normal pupil or a clear cornea do not indicate that the globe is intact. In this situation, a positive Seidel test points to urgent action: shield the eye, avoid pressure or manipulation, administer antibiotics and tetanus prophylaxis as indicated, and arrange urgent ophthalmic evaluation and imaging for surgical repair.

Open globe injury means the eye’s outer wall has a full-thickness breach, allowing intraocular fluid to escape. The Seidel test directly demonstrates this leakage: after applying fluorescein dye, a positive result shows a stream or jet of diluted dye leaking from the wound under cobalt blue light, indicating aqueous humor is escaping through a corneal or scleral rupture. This finding is highly specific for globe rupture and thus the strongest clue that an open globe injury is present.

Hyphema can occur with trauma but doesn’t prove the globe is ruptured, and a normal pupil or a clear cornea do not indicate that the globe is intact. In this situation, a positive Seidel test points to urgent action: shield the eye, avoid pressure or manipulation, administer antibiotics and tetanus prophylaxis as indicated, and arrange urgent ophthalmic evaluation and imaging for surgical repair.