Corneoscleral Laceration Workup

Updated: Nov 19, 2018
  • Author: Guruswami Giri, MD, FRCS; Chief Editor: Hampton Roy, Sr, MD  more...
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Approach Considerations

Whenever possible, a thorough eye examination should be performed. This includes assessment of Snellen visual acuity, pupillary reaction, and confrontation visual fields, as well as noncontact intraocular pressure measurement, slit-lamp examination with fluorescein stain for Seidel test, and dilated fundus examination. Seidel test results may be negative if the corneal laceration is plugged or the intraocular pressure is very low. [4]


Laboratory Studies

If the wound appears infected, Gram stain and cultures for bacteria, anaerobes, and fungi should be performed in the operating room. Swabs from the wound should be obtained before the patient is prepared for surgery with betadine. Cultures can also be obtained from any intraocular foreign bodies or tissue resected during surgery.


Imaging Studies

Imaging should be considered when an intraocular foreign body is suspected. X-ray films and CT scans are quick and can be readily obtained. MRI should not be obtained if a metallic foreign body is suspected.

A CT scan is also useful in assessing any injury to the orbital bone in patients who have sustained blunt trauma.

A B-scan ultrasound examination that is gently performed by an expert may be helpful in identifying an intraocular foreign body.


Other Tests

Consider other associated diseases such as connective-tissue disease in patients with minor trauma presenting with corneoscleral laceration. [5]