History / Objective Data
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This case was donated by Aaron Kerr, OD of Memphis, Tennessee.
A 30 y/o Hispanic male presented with complaints of a red, swollen right eye and severe headaches that began ten days previously. The patient also reported a recent history of fever, vomiting, and dizziness. The patient was non-English speaking without a translator and no ocular or medical history could be attained. Clinical Findings: Best corrected visual acuities were HM at 5 feet in the right eye and 20/30 in the left eye. Biomicroscopy of the right eye revealed 4+ conjunctival congestion (see photo), 2+ mucous discharge, and 2+ lid edema. Exophthalmometry demonstrated a 5mm proptosis of the right eye. A dilated fundus exam showed 4+ papilledema in the right eye with choroidal folds present in the inferior retina. (see photo)
Extraocular motility evaluation in that eye revealed complete restriction in all fields of gaze.
B-scan ultrasound examination exhibted no apparent retrobulbar mass.
What is this condition and how should it be managed?
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Walt Mayo, OD
Technology Director
Southern Council of Optometry
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