JAMA Clinical Challenge

Corneal Trauma in a 6-Year-Old Boy

Edmund Tsui, BMSc
Erin M. Salcone, MD
A 6-year-old boy presents with worsening photophobia, irritation, and redness in his right eye for 5 days. Three days prior to presentation, his primary care physician prescribed topical erythromycin ointment. Examination of the right eye reveals moderate conjunctival injection, a superficial-appearing corneal injury, and no evidence of a ruptured globe (Figure). Vision could not be assessed due to photophobia. Upon questioning, the child reports being poked in the eye a few times over the past week by his finger, a friend's finger, and a baseball cap. He claims that no sharp objects penetrated his eye. The remainder of the examination results are normal, including full extraocular motility and equal, round, and reactive pupils. The patient is afebrile and otherwise well.

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Author Affiliations: Dr Salcone (Erin.M.Salcone@hitchcock.org) is affiliated with Section of Ophthalmology (Department of Surgery), Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire; Mr Tsui is affiliated with Geisel School of Medicine at Dartmouth, Hanover, New Hampshire.