[GODREKR]

A 42-year-old woman was brought in by ambulance after a moderate-speed motor vehicle crash on the freeway. She was the unrestrained driver of a compact car that rear-ended another vehicle. The patient's vital signs were stable in the emergency department, and her trauma survey was significant only for facial lacerations, a nasal fracture, and right orbital swelling and ecchymosis (Figure 1). Bedside, focused, ocular ultrasonography was performed before the patient was transported to radiology for her computed tomography (CT) scans (Figures 2 and 3).

Physical examination findings.


Ocular ultrasonographic findings.


CT of the orbits.

Diagnosis
Partial globe rupture
Bedside ultrasonography demonstrated a partial globe rupture on the right, with hyperechoic blood mixed with anechoic vitreous humor. The weakened sclera showed “buckled” irregular borders, and the anterior chamber appeared compressed and flattened. The patient's CT scan of her orbits confirmed the diagnosis, and ophthalmology was consulted for emergency surgical intervention. Globe ruptures can be difficult to diagnose according to physical examination findings alone. Findings such as a hyphema, irregular pupil, and flattened anterior chamber are difficult to visualize if the patient has developed significant orbital swelling after the injury. Care must be taken to minimize the amount of pressure applied to the globe during the examination. If ultrasonography is going to be performed to evaluate for possible globe rupture, images should be acquired by floating the transducer gently over a large bed of gel applied to the closed eyelid. Applying inadvertent pressure to the globe can cause extrusion of intraocular contents. Sonolucent ocular shields are currently being developed to aid in this bedside ultrasonographic application.

[LadyCPlum]

It's rather hard to feel any sympathy for someone with her injuries, considering they would probably have been lessened had she been wearing a frigging seat belt!

[Kelseecat65]

Damn...that is a hard lesson to learn!

[LadyCPlum]

Godrekr where are you getting all these fantastic medical pics?

[vagabond]

Can you save an eye that is leaking the vitreous humor? Can it be replaced?

[GODREKR]

Originally Posted by LadyCPlum ↗

Godrekr where are you getting all these fantastic medical pics?

Various medical sites.

[mintycbo]

Eye injury scares me, bad (quite possibly a phobia.)... I think I'd take an impalement to the scrotum willingly before I'd subject my eyes to damage including rupture, being poked out. etc.

As for seat belts? I ALWAYS wear mine... I move my car from one parking spot to another 5 feet away and I put it on..just habit. in the late 80's / 90's people would say you would sustain worse injuries wearing a belt, and most people I know/knew wouldn't wear a seat belt for that reason alone.. not me..Always done so.

[LadyCPlum]

Originally Posted by mintycbo ↗

Eye injury scares me, bad (quite possibly a phobia.)... I think I'd take an impalement to the scrotum willingly before I'd subject my eyes to damage including rupture, being poked out. etc.

As for seat belts? I ALWAYS wear mine... I move my car from one parking spot to another 5 feet away and I put it on..just habit. in the late 80's / 90's people would say you would sustain worse injuries wearing a belt, and most people I know/knew wouldn't wear a seat belt for that reason alone.. not me..Always done so.

Had a friend who was scared to wear hers because she heard scare stories about how seat belts can cause internal injuries in serious car accidents. She ended up with a broken nose and fractured cheekbones after she cracked her face on the steering wheel when she was rear-ended, unbelted.

[Shakey]

Ate the windshield.

[LadyCPlum]

Originally Posted by Shakey ↗

Ate the windshield.

And passed glass through da ass