October 2021: Washing Your Hands: Even More Important Than You Think

​No pictures this time. I wish I did have images. At the time, I was focused on getting my patient out of there and thinking that I would probably sound like an idiot talking to the ophthalmologist. Fanning up and down, I could see unattached whiteness floating in the vitreous between the lens and the retinal lining of the globe. I didn't think it was blood, but there was no trauma, the patient wasn't diabetic, and he had no bleeding dyscrasias or anticoagulants on board. Frankly, I wasn't sure what I was seeing.The transfer center picked up on the first ring. "I have this patient who says he can't see out of his right eye since this morning," I said. “He can't see light, and his pupil does not react. No trauma."Within moments, the ophthalmologist was on the phone. I repeated my opening statement, going on to say that he had started to have eye irritation two weeks before, so he had scheduled an eye exam, but that was still a month and a half away. He described scleral redness without discharge. That morning, he awoke unable to see out of his right eye.I went on to describe more of the exam. The cornea and anterior chamber were clear. No hypopyon. The pupil was 4 mm and unreactive. I couldn't see anything in the posterior chamber; it looked black to me. Reporting a bedside ultrasound, I hesitated."Um, I don't know what I'm seeing, but there is whiteness between the lens and the back of the eye. It is unattached. I don't think it is blood, but I don't k...
Source: Lions and Tigers and Bears - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs