In a suspected open globe injury, the examination finding that most definitively confirms full-thickness scleral or corneal laceration even when the wound is self-sealing is:

• A Positive Seidel test with 2% fluorescein ✓
• B Reduced visual acuity
• C Deep anterior chamber compared to the other eye
• D Subconjunctival hemorrhage near the limbus

Explanation

The Seidel test uses concentrated 2% fluorescein strips — the aqueous humor (which is diluted) dilutes and changes the orange fluorescein to a bright green streaming pattern (positive Seidel), indicating full-thickness wound with aqueous leak. It is the most specific bedside test for open globe confirmation. A self-sealing wound may not stream continuously, requiring gentle pressure. VA can be reduced by many non-penetrating causes; shallow AC suggests soft eye; subconjunctival hemorrhage is common with blunt trauma and does not confirm perforation.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.