0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
JAMA Clinical Challenge |

Decreased Vision Following Eye Trauma

Rajesh C. Rao, MD; Lynn J. Poole Perry, MD, PhD
JAMA. 2011;306(23):2606-2607. doi:10.1001/jama.2011.1832.
Text Size: A A A
Published online

Extract

A 52-year-old man presented to the emergency department (ED) for evaluation after several days of increasingly blurred vision in the right eye. Nine days earlier, while he was operating an asphalt reclamation machine, the patient reported the sensation of an object striking his right eye, but he had no acute pain or change in vision. He was not wearing eye protection at the time. One day after the trauma occurred, the patient visited his primary care physician and was prescribed topical antibiotics. His past medical and ophthalmological histories were unremarkable. On examination in the emergency department, the best corrected visual acuities were 20/100 in the right eye and 20/20 in the left eye. Dilated, slit-lamp examination of the right eye revealed a self-sealing, full-thickness corneal wound and an area of iris irregularity (iris synechiae formation) (Figure 1A), minimal anterior chamber inflammation, and early cataract formation. On adduction of the eye, a large, glistening, variegated intraocular foreign body was seen encased entirely in the crystalline lens (Figure 1B). There were no additional findings in the vitreous or retina on dilated examination, including no signs of endophthalmitis. Examination results of the left eye were unremarkable.

Figures in this Article

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview

Figures

Place holder to copy figure label and caption
Figure 1. A, Slit-lamp image of the dilated right eye demonstrating iris synechiae underlying a faint, self-sealing full-thickness corneal wound (arrowhead) (original magnification ×1.0). B, Slit-lamp image on adduction of the dilated right eye, revealing a golden, intraocular foreign body within the lens (arrowhead) (original magnification ×1.6).
Graphic Jump Location
Place holder to copy figure label and caption
Figure 2. A, Orbital computed tomography image demonstrating a metallic-appearing foreign body lodged within the lens of the right eye (arrowhead). B, 3-mm intralenticular foreign body submitted as a gross pathological specimen.
Graphic Jump Location

Tables

References

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles
Jobs
JAMAevidence.com

The Rational Clinical Examination
Visual Acuity

The Rational Clinical Examination
Visual Impairment

brightcove.createExperiences();