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JAMA Ophthalmology Clinical Challenge
January 2016

Open-Angle Glaucoma and an Enlarged Superior Orbital Fissure Caused by Trauma

Author Affiliations
  • 1Department of Cornea and External Eye Disease, Moorfields Eye Hospital, London, United Kingdom
  • 2Division of Ophthalmology, University of Cape Town, Groote Schuur Hospital, Cape Town, South Africa
  • 3Division of Neurosurgery, University of Cape Town, Groote Schuur Hospital, Cape Town, South Africa
JAMA Ophthalmol. 2016;134(1):103-104. doi:10.1001/jamaophthalmol.2015.2465

A man in his 30s who had sustained a stab injury to his left orbit 15 years earlier was assessed for a proptotic left eye. His visual acuity was 6/6 Snellen in both eyes with restricted elevation of his left eye. A scar resulting from the stab wound was clearly visible just below his left brow. The pulsatile proptosis had a difference of 14 mm between his eyes. His left eye had a palpable thrill, audible bruit, chemosis, dilated conjunctival blood vessels, and a swollen upper eyelid.

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