Abstract
To determine which signs are sensitive and specific in the setting of trauma to establish the diagnosis of an occult scleral rupture. The charts of patients with presumed scleral rupture were identified retrospectively. The ocular findings among the patients who had a rupture based on findings at surgery were compared with those patients who were noted to have normal findings at surgery. Visual acuity worse than 20/400, decreased intraocular pressure, intraocular pressure less than that in the nontraumatized eye, and an afferent pupillary defect were all significant indicators of an open globe. Determining the likelihood of an occult rupture can be facilitated by noting the presence or absence of those indicators that are significant and carry a high specificity.
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