Case history
Case history #1
A young man playing football received an elbow blow to the eye. He has double vision, and the eye looks sunken. On examination, he has peri-orbital ecchymosis and mild subconjunctival haemorrhage with a posterior limit. The affected eye is enophthalmic and hypoglobic. He has diplopia on upward gaze. Hess charting confirmed depression of upgaze movement with compensatory movement contralaterally.
Case history #2
A child has fallen at play on to the corner of a table and has bruising around the eye. Since the event the child has been nauseated, may have vomited, and appears unwell. On examination, the affected eye does not show any subconjunctival haemorrhage. The child is bradycardic and hypotensive. There is limitation of upgaze movement of the affected eye on upgaze, a manoeuvre that the child was resistant to perform.
Use of this content is subject to our disclaimer