Ep 107 Blunt Ocular Trauma Live from The EM Cases Course

Blunt ocular trauma requires a systematic, physical-exam-driven approach to identify vision-threatening conditions like orbital compartment syndrome, hyphema, and globe rupture. Physical examination—specifically assessing visual acuity, pupils, extraocular movements, and intraocular pressure—remains the primary diagnostic tool, as imaging often lacks the necessary sensitivity and can delay urgent interventions. Orbital compartment syndrome demands immediate lateral canthotomy to relieve pressure, while hyphema management focuses on preventing re-bleeds through head elevation, activity restriction, and potential antifibrinolytic therapy like tranexamic acid. Globe rupture necessitates protective shielding and urgent ophthalmological consultation rather than reliance on CT scans. Throughout these emergencies, maintaining a high index of suspicion and prioritizing rapid, bedside clinical assessment over diagnostic imaging is essential for preserving patient vision.