Question

You are called into the ER to see a patient that was hit by a motorcycle while crossing the street. Examination of her right eye reveals eyelid swelling, decreased visual acuity, enophthalmos (sunken eye). She denies headache or loss of consciousness but has significant pain in her eye and cheek. You order a CT of her head, what finding do you suspect?

A. a traumatic deformity of the orbital floor
B. Bleeding in the space between the brain and the tissue covering the brain.
C. a collection of blood inside the front part of the eye
D. Corneal abrasion

Answer 1

The patient's symptoms point to a traumatic deformity of the orbital floor, also known as a blowout fracture, which is likely to be the finding on the CT scan of the head.

Step-by-step explanation:

Based on the patient's symptoms of eyelid swelling, decreased visual acuity, enophthalmos, and significant pain in the eye and cheek, the suspected CT scan finding is A. a traumatic deformity of the orbital floor. This condition, often referred to as a blowout fracture, happens when there is a break in one of the walls of the bony orbital cavity, typically the floor, caused by the traumatic impact of an object like a motorcycle. This type of fracture can lead to complications such as muscle entrapment, which can restrict eye movements, leading to diplopia, and may cause the eye to appear sunken (enophthalmos).

In this scenario, the deformation of the orbital floor can also cause the inferior rectus muscle to become trapped, which is responsible for moving the eye upward. This would further decrease visual acuity and cause pain, especially when attempting to look up. Immediate medical attention with potential surgery to repair the orbital floor and release the entrapped muscle is necessary to prevent long-term damage.