Open Globe Injury Guide: Emergency Steps to Save Your Sight
Updated: 3 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026
Quick Answer: Open Globe Injury at a Glance
An open globe injury is a full-thickness cut or defect in the eye wall, the cornea, sclera or both, caused by falls, sharp objects, accidents or explosions [1]. Symptoms include eye pain, vision loss and fluid leaking from the eye [1]. Do not touch the eye; go to an emergency room immediately [1]. Urgent surgery usually follows within 24 to 48 hours [1].
Feature | Details |
Definition | A full-thickness cut or defect in the eye wall (the cornea, the sclera, or both) [1]. |
Main causes | Falls, fights, sharp objects, motor vehicle and industrial accidents, flying debris, and explosions such as fireworks [1]. |
Key symptoms | Eye pain, vision loss, fluid leaking from the eye, a visible wound through the eyelid, and eye tissue pushed out of the eye [1]. |
Urgent rule | Do not rub, touch, or press on the eye. Go to an emergency room or an ophthalmologist immediately [1]. |
Typical treatment | Urgent surgery to close the wound, usually within 24 to 48 hours, followed by antibiotics [1]. |
How common | About 3 per 100,000 people in the United States [1]. |
Recovery | The eye usually takes at least two weeks to heal and needs protection for several weeks after that [1]. |
What the research says
Earlier repair is linked to fewer eye infections, but the evidence is limited. A systematic review and meta-analysis of 15 studies (8,497 eyes, mostly penetrating injuries and eyes with foreign objects) found that primary repair within 24 hours was associated with lower odds of endophthalmitis, a serious infection inside the eye, than repair after 24 hours (odds ratio 0.39, 95% CI 0.19 to 0.79). Visual outcomes did not differ significantly between the two timings (odds ratio 0.89, 95% CI 0.61 to 1.29). All of the studies were retrospective, so the certainty of the evidence was low. (McMaster et al., Ophthalmology, 2025) [2]
A follow-up retinal operation within about a week may help the retina. A meta-analysis of 11 studies compared early vitrectomy (within 7 days) in 235 patients with delayed vitrectomy (8 to 14 days) in 211 patients after open globe injury. The retina was reattached in 91% of the early group versus 76% of the delayed group, and traumatic proliferative vitreoretinopathy, a scarring process in the eye, occurred in 9% versus 41%. The timing of any follow-up surgery depends on the individual injury and is decided by the eye surgeon. (Quiroz-Reyes et al., Clin Ophthalmol, 2024) [3]
What Is an Open Globe Injury?
An open globe injury (also called a globe rupture) is an eye injury in which trauma has caused a full-thickness cut or defect in the wall of the eye. Doctors often call the eyeball the "globe." The eye wall has two parts: the sclera, the white part of the eye, and the cornea, the clear front window. You have an open globe injury when a full-thickness cut goes through the cornea, the sclera, or both [1]. In every case, part of the eye wall is no longer intact, which can let the eye's contents push out of the eye.
An open globe injury is very different from a corneal abrasion, which is a scratch on the surface of the cornea. Corneal abrasions are much more common and generally less severe [1].
Types of Open Globe Injury
Who Gets Open Globe Injuries?
Anyone can have an open globe injury, but studies show it is more common in men, and it happens about twice as often in men under 40 as in men over 40 [1]. Previous eye surgery, including cataract surgery, glaucoma surgery, and certain corneal transplants, can leave the protective tissues of the eye weaker at certain points and raise the risk [1].
What are the symptoms of an open globe injury?
Open globe injury symptoms may include eye pain, vision loss, fluid leaking from the eye, a visible injury piercing the eyelid and eye tissue pushed out of the eyeball [1].
Eye pain.
Vision loss.
Fluid leaking from the eye.
A visible injury that pierces the eyelid.
Extrusion of ocular tissue: eye tissue is pushed out of the eyeball.
It may not be obvious right away that an eye injury is an open globe injury [1]. If you hurt your eye in a fight, fall, or accident, go to an emergency room immediately [1].
What are the common causes of an open globe injury?
Common causes of an open globe injury include falls, scissors, fights, motor vehicle or industrial accidents and flying debris such as shrapnel, fireworks or fishing hooks [1].
Falls, especially if you hit your head. This is particularly true for people over age 75 [1].
Scissors, which injure small children who can easily get hold of them [1].
Fights, including a punch or kick to the head.
Motor vehicle or industrial accidents [1]. Flying debris at work sites can cause a globe rupture, as can the machinery itself.
Shrapnel or other flying debris, explosions (including fireworks), gunshots, knife wounds, and fishing hooks [1].
How Is an Open Globe Injury Diagnosed?
If you might have an open globe injury, don't rub or press on the eye and go to an emergency department immediately, where providers diagnose it with exams that put no pressure on the eye [1]. A provider may suspect an open globe injury from the appearance of your eye, your symptoms, and your facial injuries. The first examination should put no pressure at all on the eye [1]. Providers will likely use:
Providers avoid some tests until they know whether you have an open globe injury. For example, you should not have an MRI scan, because there may be metal debris in the eye, which would make an MRI potentially dangerous [1].
How is an open globe injury treated in an emergency?
An open globe injury is a medical emergency that most often needs urgent surgery to close wounds in the cornea and sclera, ideally within 24 to 48 hours [1]. If the trauma caused other life-threatening injuries, the healthcare team treats those first [1]. An ophthalmologist should see the eye as soon as possible [1]. While you wait for surgery, or if your open globe injury does not need surgery, follow these steps:
Action | What to do |
Protect the eye | Do not rub or touch the eye. There should be no pressure on it at any time [1]. Keep it protected with a rigid shield that does not touch the eye. |
Stay calm, head raised | Stay in bed with your head raised to about 30 degrees [1]. |
Avoid straining | Do not lift anything heavy, bend over, or strain on the toilet [1]. |
Cough and sneeze with care | It is best not to cough or sneeze, but if you must, let it out. Do not hold it in [1]. |
Control nausea and pain | Take any medicine prescribed to prevent vomiting and relieve pain. If you were given none but have severe pain or nausea, ask your provider [1]. |
Tetanus | Get a tetanus shot if you need one [1]. |
Surgery and Aftercare
Open globe injuries most often need urgent surgery, with stitches to close the wounds in the cornea and sclera. The surgeon may put eye tissue that has come through the wound back in place, or remove it if the damage cannot be repaired, and will try to bring the eye back to the correct pressure [1]. It is usually best to have surgery within 24 to 48 hours of the injury, and recovery depends on how severe the injury is [1].
After surgery, you will be prescribed topical antibiotics and possibly oral antibiotics to prevent endophthalmitis and other infections [1]. The eye usually takes at least two weeks to heal, and you will need to keep protecting it for several weeks after that [1].
The first surgery is mainly to close the eye so healing can begin [1]. Many people also have other injuries, such as retinal detachment, cataract, or iris tears, which may be treated with later surgery once the eye has started to heal [1]. You will need several follow-up appointments, and attending them is critical to the health of your eye [1].
What are the possible complications and outlook of an open globe injury?
An open globe injury is one of the most severe eye injuries, with outcomes that vary widely and possible complications such as permanent vision loss and retinal detachment [1]. Possible complications include:
Eye pain [1].
Permanent vision loss or blurry vision [1].
Retinal detachment: the light-sensing layer at the back of the eye pulls away [1].
Choroidal rupture, which can lead to significant bleeding and changes in eye pressure [1].
Phthisis bulbi: an eye with poor vision and low pressure for a long time begins to "shut down." [1]
Endophthalmitis: an infection inside the eye that can be very serious and lead to permanent vision loss or even loss of the eye [1].
Loss of the eye. This is uncommon, but it is needed in some cases where the injury is so severe that repair is not possible [1].
How Can You Prevent an Open Globe Injury?
You can't prevent every accident, but you can lower your risk of an open globe injury by keeping sharp objects from children, wearing protective eyewear and following machinery safety rules [1].
Keep sharp objects like scissors out of the reach of small children [1], and teach them to handle sharp things carefully.
Wear protective eyewear when working, playing contact sports, or playing sports that use projectiles [1].
Follow safety precautions with machinery at work, and never work with machinery while intoxicated [1].
Drive carefully and avoid physical fights [1].
Make your home safer to prevent falls: remove slippery throw rugs and clutter, and keep the lighting adequate [1].
Take extra care if you have had previous eye surgery or already have very limited vision in one eye [1].
What is the bottom line on open globe injuries?
An open globe injury is a serious emergency, and quick action gives your eye the best chance. Do not rub or press on the eye, keep it protected, and get to an emergency room or an ophthalmologist right away [1]. Surgery, careful aftercare, and every follow-up visit are the foundation of recovery, and protective eyewear is the best way to prevent these injuries.
Want more eye health and safety guides? Explore more plain-language health information at Rinnit.com.
Frequently Asked Questions
Is an open globe injury the same as a scratched eye?
No. A scratch (corneal abrasion) is a surface injury to the cornea [1]. An open globe injury is a full-thickness cut or defect that goes through the wall of the eye [1].
Can I put a bandage on the injured eye?
Do not use a soft patch or bandage that presses on the eye. Protect the eye with a rigid shield that does not touch it, and get emergency care right away.
How soon do I need surgery?
It is usually best to have surgery within 24 to 48 hours of the injury [1]. Research suggests that repair within 24 hours is associated with a lower chance of endophthalmitis [2], so surgeons aim to repair the eye as soon as possible.
What is the white part of the eye called?
The white part is called the sclera. The clear front part is the cornea. Together they form the wall of the eye [1].
Why is vomiting a concern after an eye injury?
Vomiting and straining can raise the pressure inside the eye. That is why providers give medicine to prevent nausea and ask you to avoid straining, heavy lifting, and bending over [1].
Can previous eye surgery make my eye weaker?
Yes. Cataract surgery, glaucoma surgery, and certain corneal transplants can leave the protective tissues of the eye weaker at certain points, which raises the risk of an open globe injury [1].
What is endophthalmitis?
Endophthalmitis is an infection inside the eye. It can be very serious and lead to permanent vision loss or even loss of the eye [1]. Antibiotics after surgery are given to help prevent it [1].
Will I need more than one surgery?
Often. The first surgery mainly closes the eye so it can start to heal [1]. Other injuries, such as retinal detachment, cataract, or iris tears, may be treated with later surgery [1].
Can a fall cause an open globe injury?
Yes. Falls, especially with a blow to the head, are a common cause, particularly in people over age 75 [1].
Should I try to remove an object stuck in my eye?
No. Do not try to remove an object from your eye yourself, because this can cause more damage. Keep the eye protected and get emergency care right away.
What is phthisis bulbi?
Phthisis bulbi is a condition in which an eye with poor vision and low pressure for a long time begins to "shut down." [1]
Why can't I have an MRI after an eye injury?
There may be metal debris in the eye, which would make an MRI potentially dangerous [1]. Providers use other tests, such as a CT scan of the face and jaws [1].
How long does the initial healing take?
The eye usually takes at least two weeks to heal, and you will need to keep protecting it for several weeks after that [1].
Are men more likely to have open globe injuries?
Yes. Studies show it is more common in men, and it happens about twice as often in men under 40 as in men over 40 [1].
How common are open globe injuries?
Open globe injuries are uncommon. In the United States, there are approximately 3 open globe injuries per 100,000 people [1].
Related Reading
Hyphema: A Comprehensive Guide to Symptoms, Causes, and Eye Injury Recovery covers bleeding inside the front of the eye after an injury.
Orbital Fractures: Types, Symptoms, and Treatment Pathways explains broken bones around the eye and how they are treated.
Corneal Abrasion: Symptoms, Causes, Treatment, and Recovery covers a scratched cornea, a less severe surface eye injury.
Retinal Detachment: Symptoms, Causes, Diagnosis & Treatment — Complete Guide explains retinal detachment warning signs and emergency treatment.
References
Cleveland Clinic. Open Globe Injury. Cleveland Clinic. Updated December 11, 2022. https://my.clevelandclinic.org/health/diseases/24532-open-globe-injury
McMaster D, et al. Early versus Delayed Timing of Primary Repair after Open-Globe Injury: A Systematic Review and Meta-analysis. Ophthalmology. 2025;132(4):431-441. PMID 39218161. https://doi.org/10.1016/j.ophtha.2024.08.030
Quiroz-Reyes MA, et al. Early versus Delayed Vitrectomy for Open Globe Injuries: A Systematic Review and Meta-Analysis. Clin Ophthalmol. 2024;18:1889-1900. PMID 38952722. https://doi.org/10.2147/OPTH.S466144
Medical disclaimer
This article is for general informational purposes only and does not constitute medical advice. Any injury to the eye is a medical emergency: do not rub or press on the eye, and go to an emergency room or see an eye care provider right away.
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