Signs strongly suggesting an open globe: - Irregular, peaked or teardrop-shaped pupil — the classic sign. The pupil points toward the wound because iris tissue is drawn into it. - Uveal prolapse — dark brown or black tissue at the limbus or on the sclera, or a dark plug in a corneal laceration. - Visible extrusion of intraocular contents, or a gelatinous strand of vitreous at the wound. - Shallow or flat anterior chamber — aqueous has escaped. - A 360-degree bullous subconjunctival haemorrhage obscuring the sclera, which can conceal an underlying rupture. - Hyphaema — layered blood in the anterior chamber. - Marked reduction in visual acuity, often to counting fingers, hand motion or light perception. - A full-thickness corneal or scleral laceration, or a visible entry wound. - A positive Seidel sign — fluorescein diluted by leaking aqueous, seen as a clear rivulet running through the stain under cobalt blue light. - A soft globe, though this must never be sought by palpation. - Restricted extraocular movement, which may indicate entrapment or a large wound. Symptoms: sudden pain...