Question

Wight Goodman, Patient was admitted to the floor last night from the ER for an orbital fracture. He was hit in the left eye by a softball yesterday. Apparently he was pitching, and the batter hit a line drive hitting him in the right side of the face. They applied some ice to his face, and he decided to go to the post game keg party instead of coming to the ER. The patient stated that there was significant swelling, but his vision was fine, and the pain was controlled with beer and 800mg of Motrin. He was unable to sleep later in the evening as the pain became worse, and his vision became more impaired. The Maxillofacial surgeon was consulted, and they will see him this morning. They were not concerned as his intraocular pressure was normal in the ER. There is significant edema and discoloration to the left side of his face, and his left eye is almost completely swollen shut. His visual acuity is diminished, and the whites of his eyes are hemorrhaged. His pain has been well controlled with IV morphine 4 mg, q3 hours. He has a 20g SL to his right hand, that was started in the ER. He has no other health concerns. He's being admitted for pain control, close observation of his intralocular pressure, and head injury.

Answer 1

Swelling related to meningitis can push on the optic nerve, potentially causing loss of vision by increasing the pressure in the optic nerve sheath, impacting blood flow, and nerve signals. In cases like an orbital fracture, careful monitoring of intraocular pressure is required to prevent further eye damage.

Step-by-step explanation:

Meningitis can cause swelling around the optic nerve, leading to vision loss if the swelling increases pressure within the optic nerve sheath. This pressure can impede blood flow and the transmission of nerve impulses, causing visual disturbances. Addressing the underlying cause of meningitis is crucial to reduce the inflammation and prevent further optic nerve damage.

The case of an orbital fracture, like that of Wight Goodman, is different as it involves physical trauma leading to edema and potentially affecting visual acuity if the swelling compresses the optic nerve. Intraocular pressure is tracked to prevent the development of conditions that could further harm the eye, such as glaucoma.