WIDI - CA0279-Blunt Ocular Trauma, MR

Blunt Ocular Trauma, MR

Claim CME Credit

0.5 CME Credit available on completion

POINT OF CARE INFORMATION

This CME activity consists of the student reviewing the video of the professor reviewing the case as well as the associated DICOM image set related to the case in question.

Learning Objectives

As a result of participation in this activity, participants should be able to:

Provide improved patient care.
Greater knowledge of the imaging characteristics of the patient's disease.
Understand a better approach to interpretation of studies.

Faculty Disclosure

Mehmet Albayram, MD, Ivan Davis, MD, Mariam Hanna, MD, Anthony Mancuso, MD, Ronald Quisling, MD, Dhanashree Rajderkar, MD, Priya Sharma, MD, Roberta Slater, MD and Joann Stamm, MBA have disclosed that they have no relevant financial relationships. No one else is a position to control content have any financial relationship to disclose.

CME Advisory Committee Disclosure:

Conflict of interest information for the CME Advisory Committee members can be found on the following website: https://cme.ufl.edu/disclosure/.

Continuing Medical Education Credit

Accreditation: The University of Florida College of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Credit: The University of Florida College of Medicine designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

CA0279-Blunt Ocular Trauma, MR

History

22 year old male hit in the eye by a recoiling bungee cord.

Exam

EXAM: MRI- T1 and T2 weighted images were done in the axial coronal plane with high-resolution techniques focused on the eye and orbits and anterior and visual pathways. These include fat-suppressed and images following the intravenous administration of a paramagnetic contrast agent.

Findings

Preseptal Soft tissues and Orbital Adnexa

The left preseptal soft tissues including the eyelid, conjunctival sac and lacrimal gland are swollen/edematous. There is no abnormal air collection or foreign body present.

Eyes and Optic nerves

The eye is not decompressed or enlarged. The anterior chamber is may be slightly enlarged. The lens may be displaced minimally posteriorly related to anterior chamber enlargement.

There is intravitreous hemorrhage and the choroidal tract enhances more on the left than right due in part to a likely retinal and/or choroidal contusion.

The junctions of the optic sheath/nerve and eye show edema and possible bleeding. There is evidence of hemorrhage likely within the optic nerve and sheath mainly distally at the optic nerve/sheath junction with the eye.

Orbits

The bones of the orbit including the optic canal and extraconal/intraconal orbital fat are normal. The extraocular muscles, orbital apex and superior orbital fissure appear normal.

Brain

There are no intra-axial or extra-axial abnormalities of the brain that might be related to the eye/orbital pathology.

Other findings

There are no other significant abnormalities present.

Impression

Blunt left orbital trauma with edema and likely bleeding into the optic nerve and sheath and limited vitreous hemorrhage and retinal/choroidal contusion.

Recommendations

Direct, verbal communication with the EMS was initiated emergently due to a proximate risk to the patient’s vision and for medical decision about possible optic sheath decompression surgery.