A 33-year-old male presented to the emergency department with left eye pain for one day. The onset was acute, rated at 10/10, constant, and associated with a watery discharge. The patient stated that it felt “exactly like my prior eye herpes.” The patient also noted intermittent vision loss in his left visual field. He denied any fevers, vomiting, history of HIV or oral, facial or genital ulcers. Past medical history was significant for herpes keratitis and IVDA.
A 32-year-old male presented to the emergency department with concerns about a possible infection in his left lower extremity. The patient had a history of HIV and poorly controlled type 1 diabetes. He presented with a chronic ulcer to the left medial ankle and had an incision and drainage to the area about 45 days prior.
A 62-year-old African American female with PMHx of HTN, PUD and Graves’
disease s/ p radioactive iodine (RAI), presented to the ED for
progression of bilateral vision loss to near-blindness over the past
year. She began to lose her vision one year ago, a few months after
It’s midnight on a Friday and your next patient just happens to have
been on the wrong end of a left hook. He is a 62 year old man who states
he was assaulted with a fist to the face while walking home.
EMS presents a 47-year-old male with sudden eye pain and decreased
visual acuity which occurred while he was putting drops into his left
eye. While he was retracting his lids to place the drops, his eye
“popped out” with sudden subluxation of the globe.
This 29-year-old female presented to the emergency department
complaining of feeling weak and dizzy. She admitted to being an IV drug
user and believed that someone slipped something into her food several
days ago while she had been at a truck stop diner. The patient also
stated that she was 10 weeks pregnant and recently restarted on
methadone for a “past” heroin addiction.
A 26-year-old male presented to the emergency department complaining of
severe left eye pain and loss of vision to that eye. He explains that
while cleaning he dropped a ceramic pot, which shattered, and a piece of
shrapnel stuck him in the eye. In addition to his visual complaints,
he’s been nauseous, and has vomited several times.
The case occurred at the San Antonio Military Medical Center – South
Campus (formerly known as Wilford Hall Medical Center) in San Antonio,
Texas. At the time of presentation the emergency department was a busy
Level II trauma center primarily serving active duty military personnel,
military dependents and select civilian personnel.
A 60-year-old man presents to the emergency department after a syncopal
episode. He had been drinking at a bar when he fell off the bar stool,
striking his head on the ground. He denied any chest discomfort,
shortness of breath, dizziness, palpitations or headache prior to the
incident. He came to the hospital only because EMS was called.
An assault to the face leaves your patient in need of an emergency
lateral canthotomy to relieve the pressure and preserve vision. Here is a
step-by-step pictorial guide, in case ophthalmology isn’t immediately