A patient presents with sudden onset eye pain. He states he was watching his friend’s car get towed out of a snow drift that had suddenly appeared beneath it, when the towing cable snapped and the pain began. He shows you this picture from his camera, taken right before symptom onset.
What is the best test to determine the etiology of the pain?
Answer : C. The patient possibly has a foreign body in his eye from the cable snapping and sending metal shards flying, which would result in a positive Seidel Test. While an MRI would be both diagnostic and “therapeutic” it is not recommended. Ocular US is not recommended if the possibility of globe rupture is present.
Bonus : If the pain had begun 6 hours after the picture had been taken, what condition would have been most likely?
Answer : Photokeratitis from sunlight being focused by the bright yellow car.