UNIVERSITY OPHTHALMOLOGY CONSULTANTS

 

CASE OF THE MONTH

CASE #25

 

 
OPHTHALMOLOGIC EXAMINATION
Visual Acuity    OD: Light perception with temporal projection only
 OS: 20/20 with correction
   
Intraocular Pressure  OD: < 5 mm Hg
 OS: 17 mm Hg
   
External Examination  OD: ~4 mm ptosis with minimal upper and lower lid swelling
 OS: Normal
   
Ocular Motility  Normal OU
   
Slit Lamp Examination

 OD:

  • A serpentine corneal laceration extended clockwise from the 11:00-o’clock to the 5:00-o’clock positions and then extended 3 mm posterior to limbus at 5:00 o’clock.
  • The cornea was clear; however, a partially retracted hyphema filled the anterior chamber and adhered to the anterior iris surface, precluding a view of the pupillary space and anterior vitreous.

 OS: Normal

   
Indirect Ophthalmoscopy  OD: No view of the fundus was obtained
 OS: Normal
   
B-scan Echography

 OD:

  • Total retinal detachment
  • Subretinal hemorrhage
  • Probable small intraocular foreign bodies in the anterior chamber
  • A possible intraocular foreign body inferior temporally in the 7:00-o’clock meridian
  • The patient had traumatic aphakia.

 

What treatment should the patient receive at this point?
       
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