SAEM Clinical Image Series: Atraumatic Proptosis

An 85-year-old female with a past history of hypertension presents with acute right-eye pain, redness, and proptosis/bulging for the past two months that has been worsening over the past two days. She endorses blurry vision that began two days prior. She does not use contacts or glasses. No trauma, headache, or loss of consciousness are reported. She reports a “whooshing” sound in her right ear for two to three months.

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Gaining the Diagnosis of Vitreous Hemorrhage with Ultrasound

A 54 year-old male presents to the emergency department with an eye complaint. The patient works as a cook and while cleaning the grill several hours ago felt something fly into his eye. He did not immediately feel pain, but notes blurred vision and an increasing pressure-like sensation in his left eye. He describes his left-sided blurred vision as a haziness, like cobwebs over his eye. He has been able to open his eye and keep it open without difficulty.

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By |2020-01-29T15:55:48-08:00Jan 31, 2020|Ophthalmology, Ultrasound|

SAEM Clinical Image Series: Eye Trauma and Vision Loss

globe rupture open globe

The patient is a 44-year-old male with a past history of end stage renal disease on hemodialysis, diabetes, and hypertension who presents with acute visual loss after assault 2 hours prior. He was struck in the eye by his partner’s fist (adorned with a large ring), but denies severe pain. He does endorses instant difficulty with his vision. There is no use of contacts or glasses. No other injuries, headache, or loss of consciousness are reported.

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By |2019-11-10T21:42:57-08:00Oct 21, 2019|Ophthalmology, SAEM Clinical Images, Trauma|

SAEM Clinical Image Series: Double Vision

cranial nerve palsy CN3

Chief complaint: Double vision

History of Present Illness: 61 year old female with history of HTN, DM, hyperlipidemia, and chronic low back pain presenting with double vision. She received an epidural spinal injection yesterday for the 4th time for low back pain. She was sedated for the procedure and woke up with headache, neck stiffness, and left eye “jumping around,” which progressed to double vision 1 hour later.

There was no blurry or double vision with either eye closed. She had 1 episode of emesis. She presented to the ED 24 hours later with continued headache and double vision.

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By |2019-10-30T21:13:07-07:00Oct 14, 2019|Neurology, Ophthalmology, SAEM Clinical Images|

SAEM Clinical Image Series: Seeing Stars

Seeing Stars asteroid hyalosis

[Click for larger view]

Chief complaint: Left eye pain, redness, and foreign body sensation

History of Present Illness: 39 year old man presents after metal grinding without protective eyewear three days prior.

He had felt something strike his left eye. He developed “burning” pain, tearing, and redness. Pain worsens with extraocular movements. He notes that vision in his right eye has always been worse than the left. Denies any other visual complaints.

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By |2019-09-27T21:17:56-07:00Sep 30, 2019|Ophthalmology, SAEM Clinical Images|

SAEM Clinical Image Series: Young Woman with a Headache

Headache

[Click for larger view]

Chief complaint: Headaches for 1 year

History of Present Illness: A 31-year-old woman with no significant past history presents with a dull headache.

She notes the headache is generalized, has been almost daily for a year and is worsened by bending over. She denies nausea, vomiting, photophobia, trauma, seizures, focal weakness, numbness, or vision change. Acetaminophen and ibuprofen provide only mild, short-acting relief. She takes oral birth control and her periods have been normal.

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