gms | German Medical Science

21st Annual Meeting of the German Retina Society and 8th Symposium of the International Society of Ocular Trauma (ISOT)

German Retina Society
International Society of Ocular Trauma

19.06. - 22.06.2008, Würzburg

Significance of high resolution multislice orbital CT scans to detect penetrating eye injuries in heavy eye trauma cases

Meeting Abstract

  • Carsten Framme - Regensburg/Germany
  • P. Hofstetter - Regensburg/Germany
  • S. Feuerbach - Regensburg/Germany
  • H. Helbig - Regensburg/Germany
  • A.G. Schreyer - Regensburg/Germany

Retinologische Gesellschaft. International Society of Ocular Trauma. 21. Jahrestagung der Retinologischen Gesellschaft gemeinsam mit dem 8. Symposium der International Society of Ocular Trauma. Würzburg, 19.-22.06.2008. Düsseldorf: German Medical Science GMS Publishing House; 2008. DocISOTRG2008V017

The electronic version of this article is the complete one and can be found online at:

Published: June 18, 2008

© 2008 Framme et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Purpose: To evaluate the significance of orbital CT scans to detect penetrating eye injuries in cases of heavy ocular trauma associated with massive subconjunctival or anterior chamber hemorrhage.

Material and methods: In a retrospective chart review 59 patients presented with heavy ocular trauma of unsure rupture of the globe due to subconjunctival and / or anterior chamber hemorrhage while IOP was within normal range. High resolution multislice CT scans were performed in all patients. The affected eye was examined for penetrating injury signs as abnormal eye shape, scleral irregularities, lens dislocations or intravitreal hemorrhages. Surgical sclera inspections were performed in most of the cases with a negative CT to safely rule out a perforating eye injury.

Results: In 41 out of the 59 patients CT scans showed no signs of a penetrating eye injury, which could be confirmed by scleral inspection and ophthalmologic follow-up of the patients. In 12 patients a penetrating injury was diagnosed by CT and subsequent eye surgery confirmed the proper diagnosis. In one patient CT revealed signs of eye penetration while no scleral rupture was seen during subsequent surgery. In 5 patients a penetrating eye injury was treated by ocular surgery while preoperative CT scans failed to diagnose the open globe injury. Thus, in 53 out of 59 cases CT examination achieved correct diagnosis (90%); however, regarding the open globe cases proper diagnosis could only be achieved in about 70% (12/17).

Conclusion: In about one third of all unclear cases with a penetrating injury, CT evaluation failed to properly diagnose the open globe injury. Thus, a surgical sclera inspection is mandatory in such trauma cases independently from CT results.