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Image challenge
Ocular examination without ‘eye opening’
  1. Ankit Kumar Sahu1,
  2. Sanjeev Bhoi2,
  3. Tej Prakash Sinha2
  1. 1 Department of Emergency Medicine, All India Institute of Medical Sciences, New Delhi, Delhi, India
  2. 2 Emergency Medicine, All India Institute of Medical Sciences, New Delhi, Delhi, India
  1. Correspondence to Dr Ankit KumarSahu, All India Institute of Medical Sciences, New Delhi, Delhi, India; ankitkumarsahu13{at}gmail.com

http://dx.doi.org/10.1136/emermed-2019-208711

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    Case

    A 30-year-old man presented to the emergency department (ED) after hitting his head against a boulder when he fell from a motorbike. The primary survey was normal. On secondary survey revealed multiple lacerations on the face and severe left eyelid oedema. Since the patient could not open his left eye, an emergency bedside ocular ultrasonography was performed (figure 1).

    Figure 1

    Ocular ultrasonography showing a thin rim of hypoechoic retrobulbar structure.

    Question

    What is the most appropriate diagnosis and its management?

    1. Diagnosis: foreign body in the retrobulbar space.

      Management: surgical removal …

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    Footnotes

    • Contributors All authors made a substantive contribution to the study. SB planned the case to report as an image. AKS collected the patient data and appropriate images and was responsible for the overall content as guarantor. AKS and TPS wrote the paper. AKS and SB submitted the paper. All authors endorsed the data and conclusion.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; internally peer reviewed.