Question

During a baseball game, a 22 year-old college student is hit in the right eye by a baseball. He complains of blurry vision in that eye. On physical exam, the physician assistant notes proptosis of the right eye, and limitation of movement in all directions. On CT scan, which of the following is most likely to be seen?

A. Fracture of the medial orbital wall
B. Prolapse of orbital soft tissue
C. Hematoma of the orbit
D. Orbital emphysema

Answer 1

The most likely finding on a CT scan for a patient with proptosis, limited eye movement, and a history of trauma is a hematoma of the orbit, due to direct trauma causing blood accumulation and increased intraorbital pressure.

Step-by-step explanation:

Given the clinical presentation of proptosis (protrusion of the eye), limitation of movement in all directions, and a history of trauma from a baseball hitting the right eye, the most likely finding on a CT scan would be a hematoma of the orbit. This is because direct trauma can cause blood to accumulate within the orbit, leading to proptosis and restricted eye movement due to increased intraorbital pressure. A fracture of the medial orbital wall, prolapse of orbital soft tissue, or orbital emphysema could also be possibilities, but they tend to exhibit different clinical signs such as crepitus in the case of emphysema or enophthalmos with medial wall fractures. Hematoma formation is the most consistent with the stated symptoms of sudden-onset proptosis and limitation in eye movement.