Ophtho On Call Case 9: Introduction

History of Present Illness (HPI)

A 20-year-old woman is brought into the emergency room with blurry right eye vision following an elbow to right eye collision during her state final boxing match 40 minutes ago. Emergency responders state she collapsed after her opponent’s elbow made contact with her right eye during the final moments of the match. They also noticed that her eye looks very “red.” The patient endorses blurry vision in her right eye and general pain periorbitally. Sitting quietly in the dim ER room seems to make her pain better. Periorbital pain is 8/10 while attempting to move her eyes. She denies flashes or floaters. She has not ocular history and usually sees well without glasses.

What’s at the top of your differential diagnosis? Choose at least 3 before moving on!
Retroorbital hemorrhage
Corneal Abrasion
Globe rupture
Retinal detachment
Traumatic hyphema
Traumatic iritis
Orbital fracture

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