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2007 Series -  July 31, 2007 Lecture 22 of 52  NEXT»

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A 19-year-old, African-American male reports to the emergency room at midnight. He states that 3 days prior to presentation he was punched in the eye and has had decreased vision in the eye and pain ever since.  He has no prior eye diseases or trauma.

On examination, he now has hand motion (HM) vision in the affected eye and an IOP of 70 mmHg (the IOP in the other eye is 14mmHg).  It is now 3 AM and you are about to give the patient IV Diamox to lower the IOP. You remember that you should check a “blood test” before giving Diamox in such patients.

1.  The correct lab test to order in this patient is:   
 

a. liver enzymes
b. cardiac enzymes
c. sickle cell prep and hemoglobin electrophoresis
d.  hemoglobin A1C

2.  All of the following are associated with a higher risk of a poor clinical outcome EXCEPT:  
 

a. an IOP of 70 mmHg
b. absence of corneal staining
c. a visual acuity of hand motion (HM) at presentation
d.  large initial hyphema size (>1/2)

3.  All of the following are indications for surgical evacuation of a hyphema EXCEPT: 
 
a. an IOP greater than 50 mmHg for 5 days or 35 mmHg for 7 days despite maximal medical therapy.
b. corneal stromal blood staining
c. a visual acuity of 20/200 or better
d.  total filling of the anterior chamber with blood

For answers to the above, click here on or after August 7, 2007.

 

 


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