Sclera plays an important role in protecting the eyeball, providing a strong mechanical resistance to the eye wall. Scleral wounds are extremely severe due to the high risk of infection (endophthalmitis) and have to be addressed with a high suspicion for a more extensive disruption of ocular anatomy and exposure of intraocular contents. One of the most severe forms of mechanical ocular trauma is the scleral rupture. Ruptures are caused by a blunt object which compresses the eyeball and as soon as the resistance of the eye wall is overcome, the eye wall opens at its weakest point. Due to the risk of expulsive choroidal haemorrhage, the primary repair is urgent. We present the therapeutic approach of a 55-year old male with an extensive scleral rupture and prolapse of intraocular tissues after a severe blunt ocular trauma.