History of Present Illness (HPI)
A 22-year-old male presents to the emergency department with his hand covering his right eye and groaning. He appears anxious and keeps repeating, “My eye! My eye!” He states that he was struck by a pellet. He and his friends were playing with BB guns when a BB pellet bounced off a tree and hit his left eye. He was not wearing any protective eyewear.
What’s at the top of your differential diagnosis? Choose at least 3 before moving on!
Globe rupture
Retrobulbar hematoma/orbital compartment syndrome
Orbital fracture
Orbital cellulitis
Eyelid laceration
Preseptal cellulitis
Traumatic hyphema
Orbital contusion
Traumatic iritis
Intraocular foreign body
What additional history is important to elicit? Click all that apply
Allergies
Family history of eye disease
Vaccination history
Tobacco, Alcohol, and drug history
Previous ocular history
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