SAQ 1193 – Diving-related facial trauma with visual symptoms

Marked out of 20.00

During a busy Boxing Day shift, you notice a triage note: a 32-year-old man dived into water from 10 m yesterday and now has a black eye and blurred vision. He looks well, has a black eye, cannot open it, is not distressed and was triaged category 5.

You bring him in. He has a left orbital haematoma, subcutaneous emphysema over the left orbital area, limited visual acuity to counting fingers, and diplopia in all directions. You cannot perform a satisfactory slit-lamp examination while awaiting ophthalmology. The CT you organised is shown below.

Axial CT orbit after facial trauma
CT orbit.

What diagnoses are you concerned about, and why?

(Marked out of 2.0)


/ 2

State the potential injuries to each listed ocular structure.

(Marked out of 8.0)


/ 8

What abnormalities are seen on the CT?

(Marked out of 2.0)


/ 2

What diagnosis explains his clinical signs?

(Marked out of 1.0)


/ 1

Explain how this diagnosis accounts for reduced visual acuity and diplopia in all directions of gaze.

(Marked out of 5.0)


/ 5

What temporising measure can you take in the ED while waiting for ophthalmology? Include a rationale.

(Marked out of 2.0)


/ 2

Total Score: 0 / 20

Percentage: 0%