JAMA Clinical Challenge Section Editor: Huan J. Chang, MD, Contributing Editor. We encourage authors to submit papers for consideration as a JAMA Clinical Challenge. Please contact Dr Chang at firstname.lastname@example.org
Author Affiliations: Department of Ophthalmology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
A 35-year-old man presents to the emergency department (ED) with painful vision loss, tearing, and photophobia after being struck in the left eye by a plastic pole 3 days earlier. Immediately after the trauma he went to a primary care clinic, and corneal abrasion in the left eye was diagnosed. He received topical antibiotic ointment, but symptoms and signs persisted. His medical history is remarkable for uneventful laser-assisted in situ keratomileusis (LASIK) in both eyes 5 years ago. On examination, the best corrected visual acuities were 20/20 in the right eye and 20/200 in the left eye. Examination of the left eye revealed a superior corneal epithelial defect and foreign body material over the lesion (Figure 1). The remainder of the ocular examination, including fundoscopic examination, was unremarkable, and the right eye was unaffected.
Huang Y, Huang F. Ocular Trauma. JAMA. 2012;308(7):710-711. doi:10.1001/jama.2012.9348