II. Definitions
- Globe Luxation
- Complete or partial globe prolapse from orbit
III. Causes
- Trauma
- Spontaneous
- Valsalva
- Contact Lens insertion or removal
- Predisposition
- Graves Exophthalmos
- Shallow Orbit (e.g. Apart Syndrome)
IV. Exam
- See Eye Evaluation in Trauma
- Protect globe without globe contact with shield or other protection
V. Management: Globe Reduction
- Precautions
- Avoid delays if no contraindication to reduction
- Delayed reduction risks complications (see below)
- Contraindications
- Ruptured Globe
- Associated injuries requiring surgical management (e.g. Facial Fracture, Retrobulbar Hematoma)
- Preparation
- Topical Anesthetic (e.g. tetracaine)
- Consider anxiolysis (e.g. IV Benzodiazepine)
- Consider Procedural Sedation (awake patient is preferred)
- Technique: Step 1 - Move globe equator past the upper Eyelid
- Patient maintains upright head while looking downward
- Examiner (or assistant) pinches upper Eyelid and lifts upward as much as possible
- Eyelid retractor may be used if available
- Suture may be placed for Lid Retraction if Eyelid cannot be grasped or the lashes cannot be seen
- Examiner applies finger at upper Sclera
- Technique: Step 2 - Reduce globe back into orbit
- Upper Eyelid Retraction upward is continued
- Patient looks upward
- Should allow the globe to rotate back into orbit under Eyelid
- Technique: Step 3 - Completion
- Reposition lower lid malpositioning
- Examine globe surface and fornices for foreign body or eyelash
- Repeat Eye Exam (see Eye Evaluation in Trauma)
VI. Complications
- Globe or Retinal ischemia
- Traumatic optic Neuropathy
- Exposure Keratopathy
- Corneal Abrasion
VII. References
- Warrington (2018) Crit Dec Emerg Med 32(12): 12-3
- Boesoirie (2021) Traumatic Globe Luxation, Eye Wiki, accessed 11/30/2021
Images: Related links to external sites (from Bing)
Related Studies
| Concepts | Disease or Syndrome (T047) |
| ICD9 | 360.81 |
| ICD10 | H44.82 |
| SnomedCT | 20842008 |
| Italian | Lussazione oculare, Lussazione del globo oculare |
| Dutch | verplaatsing van bol, luxatie; oog, oog; luxatie, oogluxatie |
| French | Luxation du globe, Luxation oculaire |
| Portuguese | Luxação do globo ocular, Luxação do olho |
| Spanish | Luxación del globo ocular, luxación del globo ocular (trastorno), luxación del globo ocular, Luxación del ojo |
| Japanese | 眼の脱臼, 眼球の脱臼, ﾒﾉﾀﾞｯｷｭｳ, ｶﾞﾝｷｭｳﾉﾀﾞｯｷｭｳ |
| English | luxation of globe (diagnosis), luxation of globe, Eye luxation, Luxation of globe, Luxation of eye (disorder), Luxation of eye, dislocation; eye, eye; dislocation |
| Czech | Luxace oka, Luxace bulbu |
| Hungarian | Szem luxatio, Szemgolyó luxatiója |
| German | Luxation des Augapfels |
Ontology: Luxation of globe, unspecified eye (C2881207)
| Concepts | Disease or Syndrome (T047) |
| ICD10 | H44.829 |
| English | Luxation of globe, unspecified eye |
