Case: 24 year old female is brought to the trauma Emergency room (ER) after a motor vehicle accident (MVA). She mostly received facial injuries while in the back seat without a seat belt. Patient has no past medical history (PMH) except cosmetic Laser-Assisted In Situ Keratomileusis (LASIK) on her eyes 3 years ago. Patient is complaining of decrease vision and feels something is in her eye. There are also lacerations on both eyelids and requiring pressure to hold the bleeding. What would be your next step?
Answer: Call for an emergent ophthalmic consult
The objective of the above question is to emphasize that the intraocular injuries take precedence over external injuries such as eyelids or canalicular lacerations. Patients with any prior procedures to eyes such as LASIK or cataract surgery increase the risk of an occult rupture, particularly if they complain of decreased visual acuity.
In case of previous LASIK disruption of the corneal flap may occur and may be visible on an exam. An emergent ophthalmologic consult is required.
#trauma
Reference:
Tsai TH, Peng KL, Lin CJ. Traumatic corneal flap displacement after laser in situ keratomileusis (LASIK) [published correction appears in Int Med Case Rep J. 2017 Jul 26;10 :261]. Int Med Case Rep J. 2017;10:143-148. Published 2017 Apr 19. doi:10.2147/IMCRJ.S128637
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