Which of the following signs is least likely to be associated with a ruptured globe?

The indication that bilateral ptosis is least likely to be associated with a ruptured globe is based on the understanding of the anatomical and physiological implications of such an injury. A ruptured globe occurs when the outer membrane of the eye is compromised, often leading to significant pain, vision loss, and a range of specific ocular signs.

Bilateral ptosis, which refers to drooping of both upper eyelids, is typically not a direct result of globe rupture. Instead, it may be associated with other conditions affecting the cranial nerves or muscle function. In contrast, the other signs are more directly related to a ruptured globe. For instance, hypotonia of the eyelid can occur due to muscle or nerve damage related to the injury. Exophthalmos, which is the protrusion of the eyeball, can be a result of swelling or inflammatory processes that may follow such trauma, while subconjunctival hemorrhage involves bleeding beneath the conjunctiva, a common finding with globe rupture.

Understanding these relationships is critical for recognizing the various signs and symptoms associated with ocular trauma, helping to differentiate between them effectively in clinical assessments.