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JAMA Ophthalmology Clinical Challenge
December 2017

Profound Vision Loss After a Traumatic Work Injury

Author Affiliations
  • 1Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
JAMA Ophthalmol. 2017;135(12):1440-1441. doi:10.1001/jamaophthalmol.2017.2326

A 43-year-old construction worker experienced bilateral lower extremity crush injuries after a large heavy object fell onto his thighs, traumatically amputating his right leg. He also had a left leg degloving injury, distal femur fracture, and posterior knee dislocation with bleeding through the open fractures and wounds. He was profoundly hypotensive (blood pressure, 70/40 mm Hg) and anemic (hemoglobin level, 5.6 g/dL [to convert to grams per liter, multiply by 10]) from extensive blood loss. He was urgently transfused and taken to the operating room for bilateral lower extremity irrigation and drainage and reconstruction of the left leg. Unfortunately, postoperative infection necessitated a left leg above-knee amputation.

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