Which of the following is NOT a sign associated with an open globe injury?

• A. Hyphema
• B. Comotio retinae
• C. Severe subconjunctival hemorrhage
• D. Negative Seidel's test

Answer: (D)

In open globe injuries, a key indicator is leakage of intraocular contents through a full-thickness wound. This leakage is detected with the Seidel test: if aqueous humor pours out and dilutes fluorescein, you get a positive Seidel test, which confirms a globe rupture.

Among the listed findings, hyphema (blood in the anterior chamber) and severe subconjunctival hemorrhage are common trauma-related findings and can occur with open globe injuries. Commotio retinae, a retinal whitening that follows blunt trauma, can also be seen in severe ocular trauma, including cases with globe rupture. These do not by themselves prove the globe is ruptured, but they can accompany such injuries.

Negative Seidel’s test, by contrast, shows no detectable leakage of aqueous humor. Since leakage is the defining sign of an open globe, a negative result is not a sign of rupture. Therefore, that option is not associated with an open globe injury.