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.
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%
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