Question

A 17 year-old male is accidentally struck in the right eye while playing football and is immediately transported to the hospital. In the emergency room, he complains of severe pain behind the eye as well as double vision. On examination, he has exophthalmos, cannot move his right eye upward and blood is noted in the anterior chamber. Which of the following is the most appropriate course of action at this time?

A. Apply ice packs and cold compresses
B. Immediately refer the patient to an ophthalmologist
C. Attempt to keep the patient calm and order a skull x-ray
D. Administer a dose of intramuscular broad-spectrum antibiotic

Answer 1

The most appropriate course of action in this scenario is to immediately refer the patient to an ophthalmologist. The symptoms indicate a serious eye injury that requires specialized medical attention.

Step-by-step explanation:

The most appropriate course of action at this time would be to immediately refer the patient to an ophthalmologist (Option B). The symptoms mentioned - severe pain behind the eye, double vision, exophthalmos (bulging of the eye), inability to move the right eye upwards, and blood in the anterior chamber - indicate a serious injury that requires specialized medical attention.

An ophthalmologist is a medical doctor who specializes in the diagnosis, treatment, and management of eye diseases and injuries. They would have the expertise to assess the extent of the injury and initiate appropriate treatment, which may include surgeries, medications, or further investigations.

Applying ice packs and cold compresses (Option A) might help reduce swelling and pain in some cases, but in this scenario, the patient needs urgent medical evaluation and intervention.

Ordering a skull x-ray (Option C) may not provide sufficient information about the specific injury to the eye and its surrounding structures. A focused examination by an ophthalmologist is crucial.

Administering a dose of intramuscular broad-spectrum antibiotics (Option D) is not warranted in this case as the cause of the symptoms is most likely related to traumatic injury rather than an infection.