Utility of computed tomography localization with surgical exploration in globe rupture secondary to compression–decompression mechanism

This study assessed the correlation between computed tomography (CT) and surgical localization of globe rupture in blunt ocular trauma. We retrospectively reviewed adult patients with surgically confirmed globe rupture who underwent orbital CT between 2019 and 2023. Cases of penetrating trauma and those managed conservatively were excluded. Twenty-four eyes were included (50% male, median age 69). Falls were the most common cause (54%). CT identified rupture in 21/24 eyes (sensitivity 87.5%). Most ruptures were superolateral (60%), single site (96%), and Zone 3 (52%). CT accurately localized the rupture site in 13/25 cases (52%), with the highest accuracy in superolateral ruptures (9/15). Radial and circumferential ruptures occurred in 44% and 56% of cases, respectively. Despite reasonable sensitivity, CT often failed to localize the rupture precisely. Surgical exploration remains essential for definitive diagnosis and localization in blunt trauma.