A 7yo boy presents with proptosis and periorbital edema. What is the immediate action that needs to be taken?
a. IV morphine and immediate ophthalmoscopy
b. IV morphine
c. Observation only
answer: A, IV morphine is needed as it will be potentially painful to examine his eye.
Life Threatening Ocular emergencies
• proptosis (rule out cavernous sinus fistula or thrombosis)
• CN III palsy with dilated pupil (intracranial aneurysm or neoplastic lesion)
• papilledema (must rule out intracranial mass lesion)
• orbital cellulitis
• GCA
• leukocoria: white reflex (absent red reflex, must rule out retinoblastoma)
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