Authors: Kirsty Mitchell / Editor: Steve Corry-Bass / Reviewer: William Gibbs / Codes: NeuP2, OptC1, SLO1 / Published: 18/12/2022
A 42-year-old woman presents to the Emergency Department (ED) with a few hours history of blurred vision in her right eye. She has also noticed that her pupil on that side is bigger than usual.
Systemic questioning reveals that she experiences infrequent headaches which are longstanding, relieved by paracetamol, and not related to position. She works as a carer in a local hospice, and one week ago she bumped her head while hoisting a patient. She was not knocked out and has been well since, with no vomiting or limb weakness.
She has no past medical history and is on no regular medication. She does not normally need glasses. She denies alcohol or drug use.
Examination reveals that her right pupil is 6mm, dilated and fixed. Her left is 3mm and reactive. Aside from this her neurological examination, including eye movement, is normal. Her visual acuity is 6/6 bilaterally, but she struggles to read newsprint with her right eye.
Module Content
Initial Assessment of the Eye
Eye problems account for approximately 6% of all attendances to an Emergency Department (ED) in the UK
Sudden Visual Loss
Sudden visual loss is a presentation one should expect and be prepared to see, as an emergency physician.
Corneal Injuries
Eye injuries are a worldwide cause of visual morbidity and account for approximately half of all ophthalmological attendances to Emergency Departments
6 Comments
Interesting
very useful
Good read.
intresting
Short and clear illustration of unilateral fixed dilated pupil
Great revision