A 35 year-old male complains of acute left eye pain immediately after he struck a nail with a hammer. On examination, you note that the left pupil is elliptical. What diagnostic test/procedure will most likely confirm your diagnostic suspicion?
A. flourescein staining of the ey
B. pressing on the globe to assess intraocular pressure
C. an X-ray of the orbits
D. testing the extra-ocular eye muscles
E. having the patient finger count
Answer: C, an X-ray of the orbits
This patient struck a nail (think metal splinter), pain was immediate (as the splinter entered his eye). His pupil is elliptical, indicating penetration of the globe. He needs X-ray of the globe to look for the metal splinter. Flouroscein staining is for a corneal abrasion - it should not be done if the globe is penetrated
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If you are studying for the PANCE or the PANRE I recommend these Review Books.