Swollen Eye

UnFiNiShEd CaSe CoMe BaCk LaTeR

History of Present Illness: A woman in her 40’s with a history of only seasonal allergies and so significant family history presents to the UCC with 2 months of intermittent bilateral eye itching and discharge and one day of eye discomfort.  She says her eye seems swollen today as well.  No other complaints.

Vital Signs & Physical Exam:

Vital signs are normal.  Exam is normal except for image below

Physical exam is otherwise normal except for

Initial Diagnostic Testing:

• CBC: normal
• Chem 7: normal

What is the most likely diagnosis?

• A) Preseptal cellulitis
• B) Allergic conjunctivitis
• C) Sty
• D) Horner’s

SCROLL DOWN FOR ANSWERS & 1-MINUTE CONSULT

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ANSWER:

• A) Preseptal cellulitis.  No redness seen
• B) Allergic conjunctivitis. No discharge seen
• C) Sty: no mass seen
• D) Horner’s: CORRECT, however no myosis  noted, even in dim light

1-Minute EM Consult on the topic for this case from the Emergency Medicine 1-minute Consult Pocketbook

References: association with dissection

CASE CONCLUSION:

CASE LESSONS: