Tag Archives: Eye

Should’ve worn eye protection…

February 8, 2014

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This patient was working on cutting copper wire without eye protection:

Ocular FB

 

On exam the patient had a small laceration just medial to the limbus in the scleral portion of the eye, no anterior chamber or corneal involvement.  He had a positive Seidel test (fluorcein stains vitreous green under blue light.  As the vitreous leaks out you can see green tinged fluid leaking from the area of concern). 

On CT there is a metallic fragment found in the posterior chamber indicative of a penetrating copper foreign body.  This is an ocular emergency and should prompt immediate evaluation by an ophthalmologist!

Author:  Russell Jones, MD

 

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Ruptured globe…

May 4, 2013

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Fight broke out at the local prison and this man was shot in the face with a rubber bullet…

Ruptured globe 5Ruptured globe 4Ruptured globe 3Ruptured globe 2Ruptured globe 1

The “brain” weighting CT (first figure) shows a ruptured globe with hemorrhage into the orbit.  The remainder of the figures are in “bone” weighting and show various fractures:

  1. Sagittal view of a comminuted fracture of the ethmoid sinus (medial orbital wall)
  2. Sagittal view of a comminuted fracture of the maxillary sinus (inferior orbital wall)
  3. Sagittal view of a posterior orbital fracture
  4. Coronal view re-demonstrating the ethmoid and maxillary sinus fractures

This poor fellow ended up losing his eye and going back to prison.

Author:  Russell Jones, MD

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Orbital Cellulitis

November 21, 2012

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This is a facial CT from a patient seen the other day in pediatrics with orbital cellulitis:

This is an interesting CT for several reasons:

Image #1 shows all ethmoid sinuses are opacified with destruction of the anterolateral wall of the ethmoid sinus, the cause of the orbital cellulitis

Image #2 shows a large abscess formation in the superior portion of the orbit causing…

Image #3  a significant proptosis of the left eye

Image #4 shows a frontal view further identifying the abscess.

Clinically this patient had a very proptotic eye, angry red and swollen periorbital area to the point that it was difficult to get an ocular view. 

Author:  Russell Jones, MD

Image contributor:  Ali Naqvi, MD

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