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Image challenge
Ocular chemosis, hyperaemia, extroversion and exophthalmos after facial trauma
  1. Yusuke Mori1,
  2. Ryota Inokuchi2,
  3. Kazuaki Shinohara1
  1. 1 Emergency and Critical Care Medicine, Ohta Nishinouchi Hospital, Koriyama, Fukushima, Japan
  2. 2 Health Services Research, University of Tsukuba, Tsukuba, Japan
  1. Correspondence to Dr Ryota Inokuchi, Health Services Research, University of Tsukuba, Tsukuba, Japan; intensivecareunits{at}gmail.com

https://doi.org/10.1136/emermed-2020-209597

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    Clinical introduction

    A 62-year-old woman without medical history presented with chemosis, hyperaemia, exophthalmos, extroversion and anisocoria on the left side (figure 1). She had sustained blunt facial trauma during a car accident 2 months before; an operation had been performed to correct the facial fracture. Over the next month, she experienced worsening headaches, blurred vision and pulsatile pain behind the left eye. In our ED, physical and neurological examination showed that periorbital bruit was auscultated, and dysfunction of cranial nerves III, IV and VI on the left side, respectively.

    Figure 1

    The left eye shows eyelid extroversion, swelling (arrow), chemosis and …

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    Footnotes

    • Presented at This work was performed at Ohta Nishinouchi Hospital.

    • Contributors All authors were involved in the care of the patient. RI wrote this article. YM selected and described the images. KS supervised the writing of this report.

    • 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 and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

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