Trauma Nurse Core Course (TNCC) Practice Exam

A 35-year-old male presents with facial trauma and a tear-drop shaped left pupil. What type of injury is suspected?

1. Oculomotor nerve palsy

2. Globe rupture

3. Uncal herniation

4. Retinal detachment

The correct answer is: Globe rupture

In cases of facial trauma where a tear-drop shaped pupil is observed, the most likely concern is globe rupture. This characteristic pupil shape is often referred to as a "teardrop pupil" and indicates potential damage to the eye’s structures, specifically the globe, which is the eyeball itself. When there is an injury that causes globe rupture, there's usually associated loss of intraocular contents, resulting in the abnormal shape of the pupil. Globe rupture can happen due to blunt trauma or penetrating objects that exert force on the eye, leading to its compromise. The teardrop shape occurs primarily due to the displacement of the iris as a result of the injury, typically in conjunction with other signs of ocular trauma, such as the presence of vitreous hemorrhage or hyphema. Recognizing a tear-drop pupil is crucial in assessing ocular trauma, as it often necessitates urgent intervention to preserve vision and manage complications. It is vital for trauma nurses and healthcare providers to quickly identify this sign and take appropriate action to evaluate and treat the injury, which underscores the severity of the situation.