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Our Diagnosis: Orbital air (orbital emphysema) from air entering orbital compartment due to orbital fracture and the large pocket of orbital air compresses the optic nerve transiently.
Your Differential:
Preparation Planning : Case Review #31921378
Malmö, Sweden
September 2021
Assignment Instructions
Purpose
The purpose of this assignment is to work through one case at a time of a patient presenting with Transient Visual Loss. The order in which you request information, and your text responses will be and provided to the instructor. The goal of this exercise is to enhance classroom discussion and your answers may be presented in the class as talking points.
How to Complete the Assignment
The assignment requires you to investigate the patient history and additional patient results to determine a differential diagnosis. The elements of the history can be requested in any order you think is appropriate. You will be required to select each element of the history you think is most relevant to the patient’s chief complaint in a step-by-step manner, then you will be given the patient history for your inquiry, and then you will enter a free text response to indicate if the information was helpful in determining your diagnosis, and then you should enter you current differential diagnosis in order of most likely and what causes can be eliminated from your differential at that point in the process. You will then repeat the process to determine other parts of the history that you think are the most relevant, until you are ready to submit your refined differential diagnosis of probable entities, ranked in order of their likelihood. You may enter your differential diagnosis at any time by clicking the "Differential Diagnosis" button. Once the diagnosis is submitted the assignment is complete and no further action is required until attending the lecture, where each case will be discussed as a group interaction.
Materials
You are provided a suggested outline for taking a history from a patient presenting with the symptom of Transient Visual Loss.
After the Lecture
You will be provided with a link to review the suggested way to work through the case along with keys points for evaluating each piece of the information from the patient history.
Patient Presentation
A 26-year-old male was taken to the emergency room after being involved in a motor vehicle accident with subsequent transient visual loss.
What would you like to know?
You will examine each topic of patient history individually. You should select the area of history you want to examine in order of importance to reach your differential diagnosis.
Please Select One of the Options Above
Exam Results
On exam, during the episode the vision was bare light perception OD and 20/20 OS.
There was a rather large relative afferent pupil defect in the right eye.
Ocular motility was normal.
Intraocular pressure was 26 mm Hg OD and 15 mmHg OS.
A few minutes later, vision returned to 20/20 in the right eye and there was no RAPD.Dilated fundus exam revealed a normal retina and optic nerve.
