Which of the following symptoms could suggest a ruptured globe?

The presence of a tear drop pupil is particularly indicative of a ruptured globe. This occurs when the integrity of the eyeball is compromised, leading to changes in the shape of the pupil. Normally, the pupil is round, but when there is damage to the eye, such as a rupture, the pupil may take on a tear-shaped or irregular appearance. This is a classic sign that suggests significant trauma and potential leakage of intraocular contents, which necessitates urgent medical intervention.

Other symptoms, while relevant to eye injuries, do not specifically indicate a ruptured globe in the same way. Constricted pupils could suggest other issues, such as exposure to certain medications or conditions, rather than a rupture. Decreased visual acuity is significant and can occur in many types of eye injuries, not strictly indicating a rupture. Photophobia, or sensitivity to light, can be a symptom resulting from various eye conditions including infections, inflammation, or trauma, but it is not exclusive to a ruptured globe. Thus, the tear drop pupil stands out as a specific and critical sign of this serious ocular injury.