The EM Educator Series: Hey Doc, I can’t see

Authors: Alex Koyfman, MD (@EMHighAK) and Lauren White, MD // Edited by: Brit Long, MD (@long_brit) and Manpreet Singh, MD (@MprizzleER)

Welcome to this week’s EM Educator Series. These posts provide brief mini-cases followed by key questions to consider while working. The featured questions provide important learning points for those working with you, as well as vital items to consider in the evaluation and management of the specific condition discussed.

This week has another downloadable PDF document with questions, links and answers you can share with learners as educators in #MedEd. We are working on retroactively doing this for the past posts as well. Please message us over Twitter and let us know if you have any feedback on ways to improve this for you. Enjoy!

Mini-Case:

#1: A 36-year-old male was assaulted by several assailants. He suffered severe facial trauma. His airway is intact, and his GCS is 15. He is currently complaining of decreased vision in the right eye, with severe pain and swelling. His IOP is 45 mm Hg.

Considerations:

1. Compartment syndromes occur throughout our body, besides orbital compartment syndrome. What are other forms you should consider?
2. What are the etiologies of orbital compartment syndrome?
3. What is the differential of acute vision loss, painful vs. painless?
4. How do you diagnose orbital compartment syndrome?
5. How do you perform the procedure, and what do you need to perform it?
6. Who needs an emergent Ophthalmology consult?

Suggested Resources:

• Articles:
  • LITFL – Bashed, Blind and Bulging
  • emDOCs – Acute Visual Loss in the Emergency Department: Pearls and Pitfalls
  • CORE EM – Non-Traumatic Monocular Vision Loss
  • CORE EM – Traumatic Ocular Injuries
  • First 10 EM – Procedure: Lateral Canthotomy
• Podcast:
  • EM Cases – Blunt Ocular Trauma Live from The EM Cases Course
• Videos:
  • Larry Mellick – Lateral Cathotomy and Cantholysis
  • EM:RAP – How to do a lateral canthotomy