JAMA Clinical Challenge
Yi-Hsun Huang, MD
Fu-Chin Huang, MD
A 35-year-old man presents to the emergency department (ED) with painful vision loss, tearing, and photophobia after being struck in the left eye by a plastic pole 3 days earlier. Immediately after the trauma he went to a primary care clinic, and corneal abrasion in the left eye was diagnosed. He received topical antibiotic ointment, but symptoms and signs persisted. His medical history is remarkable for uneventful laser-assisted in situ keratomileusis (LASIK) in both eyes 5 years ago. On examination, the best corrected visual acuities were 20/20 in the right eye and 20/200 in the left eye. Examination of the left eye revealed a superior corneal epithelial defect and foreign body material over the lesion (Figure). The remainder of the ocular examination, including funduscopic examination, was unremarkable, and the right eye was unaffected.
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Author Affiliations: Drs Huang (firstname.lastname@example.org) and Huang are affiliated with the Department of Ophthalmology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.