A 28-year-old man sustains penetrating injury to the right eye with a metal fragment. Slit lamp shows a full-thickness corneal laceration, iris prolapse, and flat anterior chamber. Intraocular pressure is 4 mmHg. According to the Birmingham Eye Trauma Terminology (BETT) system, this is classified as:

• A Closed globe injury — lamellar laceration
• B Open globe injury — perforating injury
• C Open globe injury — intraocular foreign body (IOFB)
• D Open globe injury — penetrating injury ✓

Explanation

Under BETT: a penetrating injury is a single full-thickness wound of the globe without an exit wound. A perforating injury has both entry and exit wounds. An IOFB is a retained foreign body inside the globe after entry. A lamellar laceration is a partial-thickness wound — closed globe injury. This case has a full-thickness corneal wound (open globe) from an entry wound only — no exit wound is described — consistent with penetrating injury. If the metal fragment is still inside, it would be classified as IOFB.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

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Written and medically reviewed by the StethoPrep medical team.