In the field, how should a casualty with an open globe injury be managed?

• A. Evac immediately without shielding
• B. Apply direct pressure to the eye and rub it
• C. Do not apply pressure on the eye; cover with a protective shield; evac
• D. Remove eye prosthesis

Answer: (C)

Open globe injuries are surgical emergencies where the eye’s outer wall has a full-thickness breach, so preventing further damage and infection while getting to definitive care is the priority. The best field action is to shield the eye with a rigid, protective cover to stop any contact or pressure on the eye and to keep the wound from moving or being rubbed. Do not press on or rub the eye, and avoid trying to inspect or manipulate the injury or apply eye drops directly in the field. Rapid evacuation to a facility that can surgically repair the eye is essential. If available, start broad-spectrum antibiotics and provide tetanus prophylaxis to reduce infection risk during transport.