Persistent Cough and Ptosis

Post by @Fteranmd 55 yo M active smoker presents to the ED complaining of months of persistent cough, associated with difficulty reading due to inability to fully open his left eye. Physical exam is remarkable for findings shown in the picture above. Patient is otherwise well-appearing and has normal vitals. A chest x-ray is obtainedRead more

New Year’s Eye-ve

A 53 year old man presents with severe sudden onset pain in his left eye associated with nausea and cloudy vision. He describes seeing halos around lights. His symptoms started when he entered a dark nightclub where he was planning to celebrate New Year’s Eve.   What would you do next? How would you treat thisRead more

Eye Caramba!: Management of Corneal Abrasions

A 25 year old male basketball player presents with R eye pain after being elbowed in the eye one hour prior to arrival.  The eye is tearing and very painful, although his vision is preserved, and he feels that something may be stuck in the eye. Exam of the eye shows PERRL, EOMI, 20/20 visualRead more

Red Eyes

Hyphema (RBCs in anterior chamber): from trauma, inflammation, pathologic neovascularization  Read more

A 60 yo F with sudden onset loss of vision in right eye, painless.  Proceeded by a few episodes of amaurosis fugax. Physical exam: pupils appear normal on initial inspection, however afferent pupil defect noted. Fundoscopic exam: cherry red spot, pale retina, +/-boxcar segmentation (not shown in this picture). DDx for loss/reduction of vision: Glaucoma,Read more

22 Yo Woman with 2 Days of Headache

Case as discussed in today’s morning report by Dr. Lim. Thanks to Dr. Gardner for some thought-provoking questions leading to an excellent discussion. 22F no sig pmhx presented to the ED with 2d of a global, gradual-onset, throbbing headache. No similar or frequent headaches prior. Has also had URI symptoms the past few days includingRead more


Bonus Pearl – For the previously missed one… 70 y/o  M presents with flashing lights and floaters in R eye.   He also notes decreased vision in the same eye.  R eye is painless and not TTP.  No swelling noted.  Visual acuity is 20/200 in the R eye and 20/30 in the left eye.  YouRead more

A 44 year old female with HTN, DM, and psychiatric disease presents with non-traumatic pain and vision loss in her right eye for 12 hours.  She has a right sided throbbing headache. On exam she has a 5mm R pupil which is sluggish to react, 3mm L pupil that is fully reactive. Her R eyeRead more

Daily Em Pearl, 5/5/12

A young lady presents to your ED a few hours after a fist fight, c/o L-eye pain. She does not wear contacts and has tried ice and ibuprofen for the pain but noticed her eye was very red, so she came in for help. You do a complete eye exam, including visual acuity and aRead more

daily EM pearl, 4/14/12

A young woman is BIBEMS to your trauma bay. She has been assaulted, has multiple signs of trauma with a GCS of 6 and saliva is noted to be pooling in her mouth and onto the bed. After a swift and successful intubation you further assess the patient. Her right eye is proptotic and sheRead more