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Question: Eye problem

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Teardrop pupil

A 2 year old toddler comes in from the playground crying and rubbing at his right eye. Exam is as above.

What is the best management?

pemsou5_wp • February 6, 2018

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  1. Kelly February 6, 2018 - 10:52 am Reply

    B. This teardrop shaped pupil is a sign of globe rupture occurring at the limbus, often from blunt trauma with sudden increase in intraocular pressure (IOP). In addition to the management in choice B, anti-emetics as needed to avoid vomiting and resultant increases in intraocular pressure, broad spectrum IV antibiotics, and tetanus update as needed should be given. No pressure should be placed on the eyeball, including through measuring IOP or bedside ultrasound as in choice D. The management in choice C is appropriate for hyphema.

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