Vitals: Temp: 37C, BP: 140/80, HR 82, RR 12
VA with correction: OD 20/200, OS 20/30
Intraocular pressures (IOP) by tonopen: OD 52 mmHg, OS 13 mmHg
Confrontation Visual Fields (CVF): OD constricted 360, OS full
Below is an image of what you see on external exam of the right eye:
In the right eye, there is conjunctival injection, corneal edema, a shallow anterior chamber, and a mid-dilated pupil.
External examination of the left eye is grossly within normal limits.
When flourescein is applied, there is no staining of the cornea in either eye.
You attempt a fundoscopic exam of the right eye, but the view to the posterior pole is poor through the corneal edema.
Undilated fundoscopic examination of the left eye reveals a healthy optic nerve without disc edema or pallor and cup-to-disc ratio of 0.3. There are a few dot-blot hemorrhages and microaneurysms in the macula. The rest of the fundoscopic exam in this eye is within normal limits.
You call an urgent ophthalmology consult.
Click here for the ophtho exam!
Case 8 Index
Case 8 Introduction