Spontaneous Globe Rupture due to Neglected Glaucoma: How can it be? Poster Presentation - Case Report - General practitioner

Abstract

Introduction
Globe rupture is usually associated with spontaneous traumatic processes with the worst prognosis.
The occurrence without prior trauma is only reported in small numbers of cases. This paper will
describe a globe rupture in glaucomatous eye and share our experience with its management.

Case Illustration
A 66-year-old male presented to the emergency department (ED) with reddish and progressive pain
in the right eye (RE) followed by severe headaches for the last three days. On history taking, the
patient complained of a progressive blurry vision to total blindness of his RE for 1 year. The patient
admitted to having a history of glaucoma on previous primer examination but did not routinely
control it. On initial examination, the patient was hypertensive , and suddenly began bleeding within
10 minutes upon arrival at ED. The diagnosis of globe rupture was made and he underwent
emergency evisceration.

Discussion
Spontaneous globe rupture is very rare, with an incidence of 3 per 100.000 in the United States,
while no definite number is found in Indonesia due to the rarity. In glaucoma patients, spontaneous
globe rupture is postulated to occur due to suprachoroidal hemorrhage. Our patients had multiple
risk factors such as advanced age, systemic hypertension, and chronic untreated glaucoma.
Evisceration went down to reduce pain, stop bleeding and prevent the spread of infection.
Performing surgery within 10 days of the initial injury suggests a lower risk of post-operative
endophthalmitis or sympathetic ophthalmia.

Conclusion
Spontaneous globe rupture in neglected chronic glaucoma has a very poor outcome but preventable.