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Scleral perforation is a full-thickness hole or defect in the sclera. It is a type of open globe injury when the wall of the eye has been breached, and it can lead to loss of intraocular contents. Trauma is a common cause, but severe scleral melt from inflammation or infection can also perforate. This is an eye emergency that needs immediate specialist care.
read more about scleral perforation ...Blunt or sharp trauma can tear the sclera, including high-speed impacts, falls, and penetrating injuries. Surgical complications can rarely create a perforation, especially in fragile tissue or complex procedures. Necrotizing scleritis and scleral melt can thin the wall until it gives way, sometimes with uveal tissue prolapse. Infections that erode scleral tissue also raise perforation risk, particularly after prior surgery or trauma. In many cases, more than one risk factor is present, such as thinning plus a minor injury.
Symptoms can include sudden severe pain and a rapid drop in vision. Some people notice a misshapen pupil, new double vision, or a visible dark tissue bulge at the injury site. Bleeding, swelling, and a very soft-feeling eye can occur, though not every sign is obvious without an exam. Clear fluid leakage from the eye surface is a red flag for an open globe. Any suspected perforation should be treated as an emergency, even if pain is not intense.
Diagnosis is based on urgent clinical assessment, with careful handling to avoid worsening tissue loss. An eye doctor evaluates the wound, checks for uveal prolapse, and assesses anterior chamber depth and pupil shape. Imaging such as CT can help identify a foreign body or deeper injury, while ultrasound is used cautiously and only when safe. Vision testing and assessment of associated corneal, lens, and retinal injuries guide prognosis. The care team also checks tetanus status and starts infection prevention steps based on standard open globe protocols.
Primary treatment is surgical closure of the scleral defect to restore globe integrity. The surgeon repairs the wound with fine sutures and addresses associated damage when possible, such as prolapsed tissue management or lens injury. Systemic antibiotics are commonly used because open globe injuries carry high infection risk. Activity restriction and protective shielding reduce risk of re-injury during healing. Additional procedures can be needed later if retinal detachment, cataract, or scarring develops.
Yes, scleral perforation is a form of open globe injury because the wall of the eye has a full-thickness defect. Open globe can involve the cornea, sclera, or both. The term describes the urgency and the infection risk. Prompt surgical repair is standard care.
Yes. Necrotizing scleritis and scleral melt can thin the sclera until it perforates. This can happen with autoimmune disease or infection, and it can progress quickly when inflammation is active. Early treatment aims to stop tissue loss before the wall fails. A specialist monitors closely when thinning becomes advanced.
If perforation is suspected, protect the eye and avoid pressing on it. Do not attempt to rinse deeply, remove an embedded object, or place pressure patches on the eye. Avoid eating or drinking in case urgent surgery is needed. Seek emergency ophthalmic care right away.
Ocular Penetrating and Perforating Injuries. EyeWiki. https://eyewiki.org/Ocular_Penetrating_and_Perforating_Injuries. Date Accessed February 4, 2026.
Open Globe Injury: Assessment and Preoperative Management. American Academy of Ophthalmology (EyeNet). https://www.aao.org/eyenet/article/open-globe-injury. Date Accessed February 4, 2026.
Globe Rupture - StatPearls - NCBI Bookshelf. StatPearls (NCBI Bookshelf). https://www.ncbi.nlm.nih.gov/books/NBK551637/. Date Accessed February 4, 2026.
Scleral Perforation as a Complication of Strabismus Surgery. PubMed. https://pubmed.ncbi.nlm.nih.gov/34928765/. Date Accessed February 4, 2026.
Open Globe Injury: Symptoms, Causes & Treatment. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/24532-open-globe-injury. Date Accessed February 4, 2026.