Case Studies in Ophthalmology
Cases for the Ophthalmology Clerkship
Note to Medical Students on the Ophthalmology Rotation at the University of Iowa:
Print the question and answer sheet (Ctrl-Print or Command-Print) and enter your answers on it. You may prefer to type your answers on this page and then print it. If you do this, be careful that your full answer shows in the printout. Experience with Internet Explorer has been less than optimal.
Return the printed copy with your answers to Michelle Snyder or Dr. Kemp via campus mail (11290 PFP) or scan as a pdf and email to Michelle at michelle-r-snyder@uiowa.edu or Dr. Kemp at pavlina-kemp@uiowa.edu.
Case #8 Intraocular Foreign Body
History
A 28-year old farmer felt a sharp pain in his right eye while hammering on a bearing. There was no apparent change in his vision.
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Question #1
What is your strategy for evaluating this patient and what should be your greatest concern?
Questions #2
If ophthalmoscopy of the disc and macula are within normal limits, how would you proceed?
Questions #3
How could you explain the absence of an afferent pupillary defect and a visual acuity of 20/200 or less in some cases of ocular trauma?
Questions #4
Describe the typical signs of anterior and posterior segment trauma resulting from an intraocular foreign body.
Questions #5
What measures should be taken in transferring patients with penetrating ocular injuries to other medical centers?
Question #6
What options are available for removing an intraocular foreign body?
Question #7
Would your management differ if the foreign body were iron, copper, glass, or wood?
References
Paton D, Goldberg MF: Management of Ocular Injuries, 2nd edition. Deutsch TA, Feller DB(eds.), Philadelphia: WB Saunders, 1985.
Packer AJ: Ocular Trauma. In Primary Care: Ophthalmology in Office Practice. Folk JC, Rakel RE (eds.), Philadelphia: WB Saunders, 1982.