The baffling case of bilateral luxated globes
Globe luxation is a rare, uncommon entity that presents in a dramatic fashion. It is characterised by the anterior displacement of the equator of the globe beyond the palpebral aperture.

Published in the Digital Journal of Ophthalmology, the authors report a case of a fifty-year-old man who was referred for bilateral prominence of eyes since birth with the increased prominence of left eye along with redness, pain, discharge and progressive diminution of vision since one week.

Significant family history of similar prominence of both eyes in father and brother was given by patient. On examination, Best corrected visual acuity was 6/24 in RE and perception of light in LE. While extraocular movements were normal in RE, they were restricted in all gazes in LE. RE cornea was 9 mm in diameter. Eye closure was adequate.

LE conjunctiva was chemosed, congested and keratinized with mucopurulent discharge while cornea was lustreless, hazy and an intrastromal abscess was present. Iris and lens details were not made out. Eye closure was absent. All routine blood investigations were within normal limits. The patient underwent medical management but progression was noted and eventually, LE developed panophthalmitis and no perception of light and was eviscerated.

Lessons learnt:-
- This is a rare case of congenital, bilateral luxated globes with left eye Panophthalmitis following corneal ulcer perforation.

- Traumatic globe subluxation occurs after direct trauma. In this case however, bilateral prominence of eyes was present since birth and patient gave history of being able to close both eyes with effort, till a month back.

- The patient builds up posterior pressure behind the globe, causing it to protrude and ‘’pop out’. The exposed cornea, upon losing moisture induces a blink reflex, thereby causing contraction of the orbicularis muscle. This configuration then ‘’locks’’ the protruded eye, thereby making manipulation and repositioning tough.

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