A 6-year-old girl has had a cold for a week and two days of increasing redness and swelling of her left eyelids. Today she is feverish (38.9 °C) and miserable. Her mother says the eye "looks pushed forward". The child says it hurts to look up and that she is seeing two of everything. On examination the upper and lower lids are red and tense; when they are gently parted the conjunctiva is swollen and the eye is displaced forward and down. She cannot look upwards fully with that eye. Visual acuity is 6/9 on the left and 6/6 on the right.
Which one of the following is the most appropriate management?
Keep going — a set of ten like this one, one at a time.
Practise moreMore from Paediatrics
See allA couple attend for genetic counselling. Their 3-year-old son has cystic fibrosis, confirmed by newborn screening and genotyping; both parents are carriers of a…
Foundations · common
A 10-day-old boy born at term is brought in with two days of poor feeding, vomiting and lethargy, and today is floppy and grey. He is afebrile, with a heart rat…
Clinical rotations · niche
A 2-year-old boy weighing 12 kg has had two days of vomiting and profuse watery diarrhoea. He is now floppy and barely responsive, with cool mottled legs, a cap…
Clinical rotations · common
A 9-month-old girl was eating grapes when she suddenly began to struggle. When you reach her she is conscious, silent, not crying and not coughing, with her mou…
Clinical rotations · common
A 3-year-old girl has refused to walk or stand since waking this morning and screams when her right leg is moved. She had a cold last week. Her temperature is 3…
Pre-internship · common