Eyes & ENT · Explanation & counselling

Orbital floor fracture

Medium

10 min station · 2 min reading · Curtin Year 4

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Q D G W

2 min reading · 10 min station · reminders at 2 min

Instructions

You are a medical student on placement in the emergency department. Your next patient is Neil Hobbs, 24, a landscaper, who has double vision two days after being punched in the left eye; his CT shows a fracture of the floor of the left eye socket and he has been told only that a bone is broken.

  1. Take a focused history

  2. Explain the diagnosis and your management plan to the patient

  • You do not need to examine the patient
  • You do not need to summarise to the examiner

ED registrar's eye findings (today)

Acuity 6/6 each eye; pupils equal, no afferent defect. Left lids bruised, settling; eye not bulging or sunken. Left eye does not look up fully; vertical double vision on upgaze; other movements full. Reduced feeling over left cheek, side of nose and upper lip. Eye pressures and fundi normal.