In the initial management of open globe injury, the MOST important step before surgical repair is:
- A Administering a rigid protective shield and avoiding any pressure on the globe ✓
- B Immediately patching the eye and measuring IOP
- C Instilling topical antibiotic drops and applying a tight pressure patch
- D Removing any visible foreign body to prevent infection
Correct answer: A. Administering a rigid protective shield and avoiding any pressure on the globe
Explanation
Open globe injury requires a rigid protective shield (Fox shield or improvised equivalent) placed over the orbit without any contact or pressure on the globe. Any pressure — including tight patching, tonometry, or eyelid squeezing — can extrude vitreous and uveal tissue, worsening the injury. Visible intraocular foreign bodies must NEVER be removed before surgical repair in an operating theatre setting, as doing so can precipitate collapse of the globe. Topical drops should be avoided in suspected open globe.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
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Written and medically reviewed by the StethoPrep medical team.