JAMA Clinical Challenge | Clinician's Corner

Ocular Trauma

Yi-Hsun Huang, MD; Fu-Chin Huang, MD
JAMA. 2012;308(7):710-711. doi:10.1001/jama.2012.9348.
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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 1). The remainder of the ocular examination, including fundoscopic examination, was unremarkable, and the right eye was unaffected.

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Figure 1. Slitlamp image of the corneal abrasion with epithelial defect at superior part of the cornea. Foreign body materials were also present.
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Figure 2. Slitlamp image of patient's left eye after repositioning of a traumatic laser-assisted in situ keratomileusis (LASIK) flap dislocation.
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