Corneoscleral Laceration

Updated: Nov 02, 2023
  • Author: Guruswami Giri, MD, FRCS; Chief Editor: Hampton Roy, Sr, MD  more...
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Overview

Background

A corneoscleral laceration is an injury involving the cornea and sclera and may occur following blunt, penetrating, or perforating ocular trauma. [1] The injury may be sustained at work, during sports, following a motor vehicle accident, from airbag inflation, or in a brawl. The laceration may be the only injury; injuries to other structures in the eye such as the lens, uvea, retina, or vitreous may cause prolapse through the wound. A corneoscleral laceration is more likely to occur in an eye that has undergone a previous surgery, such as extracapsular cataract surgery. [1]

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Epidemiology

Frequency

United States

The exact incidence of corneoscleral laceration in the United States is unknown, but the overall estimated rate of all eye injuries ranges from 8.2-13 per 1000 population. Eye injury rates are highest among individuals in their 20s, males, and whites. [2, 3]

International

The incidence of corneoscleral laceration worldwide is unknown.

Mortality/Morbidity

Predicting the visual outcome in patients with corneoscleral lacerations is difficult. The outcome is generally poor in patients who have poor visual acuity at presentation, in patients with delayed presentation, and in patients who sustain agricultural-related injuries. [1]

Sex

Corneoscleral lacerations are more common in young men than in young women.

Age

Corneoscleral lacerations are most common in young adults. Wound dehiscences after ocular surgery, such as cataract surgery and corneal transplantation, are most common in older patients. [4]

Sharifi et al reported results from a cross-sectional study on 80 confirmed cases of ocular trauma. Corneoscleral laceration was the most common injury, followed by iris laceration, uveal prolapse, hyphema, and cataracts. [5]

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Prognosis

Prognosis depends on several factors. [1, 6]

Patients with a small corneoscleral laceration without any other intraocular injury have a better prognosis.

Patients with other intraocular injuries, intraocular foreign bodies, endophthalmitis, late presentation, or agricultural-related injuries tend to have a poor prognosis.

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