Ocular Trauma — Evaluation

A 32-year-old male labourer presents to the emergency department 2 hours after a hammer strike to his left eye while working. He reports sudden vision loss and severe pain. On examination, the cornea appears hazy with a central dark spot. Anterior chamber is shallow with blood-stained fluid. Intraocular pressure is 42 mmHg. B-scan ultrasonography shows a hyperechoic lesion at the posterior pole with vitreous haemorrhage. What is the most likely diagnosis?

A 28-year-old male presents to the emergency department 2 hours after a hammer strike to his left eye while working. He reports severe pain, blurred vision, and photophobia. On examination, the cornea appears hazy with a central opacity. The anterior chamber is deep and quiet. Intraocular pressure (IOP) is 48 mmHg. Fundoscopy cannot be performed due to corneal opacity. What is the most appropriate immediate next step in management?

In a patient with suspected globe rupture following blunt ocular trauma, which clinical finding is most indicative of full-thickness corneal or scleral laceration?

A 35-year-old construction worker presents 4 hours after a penetrating injury to the right eye from a metallic fragment. Visual acuity is hand motions. On slit-lamp examination, there is a 3 mm corneal laceration with iris prolapse, and the anterior chamber is shallow with fibrin. The pupil is mid-dilated and non-reactive. Intraocular pressure is 8 mmHg. What is the most critical immediate action before any other intervention?

A 32-year-old male factory worker presents to the emergency department 2 hours after a high-velocity metallic projectile struck his left eye while grinding steel. He reports sudden vision loss and severe eye pain. On examination, the eye is markedly injected with corneal opacity obscuring the view of deeper structures. Intraocular pressure (IOP) is 8 mmHg. B-scan ultrasonography reveals a hyperechoic linear density within the vitreous cavity. Which of the following is the most appropriate next step in management?