SGD CASE ORBIT #1: For March 15, 2021
A 42 year-old anatomy professor was seen in the
LEVEL I
(BATCH
2024)
AY 2020-2021
NEU GROSS IHS
SGD DATE: March 15, 2021
10:00am to 11:00am
SGD SUBMISSION PORTAL:
https://college.neu.edu.ph/mo
d/assign/view.php?id=132702
due on: MARCH 15 , 2021
8:00 AM
REFERENCE:
University of Michigan
Department of Surgery-
Division of Anatomy
Emergency Department following a contusion to an
unprotected right eye by a flying golf ball while passing
thru a golf-course based hospital in Quezon City.
He sustained no alteration of mental status following the
incident, but complains of significant pain in the orbit and
periorbital region and right cheek.
His vital signs were stable with a heart rate of 84, a
respiratory rate of 16, blood pressure of 134/82,
temperature of 98.8 F, and a pulse oximetry of 99%. His
heart rate and rhythm were regular without murmurs, the
lungs were clear anteriorly and posteriorly bilaterally, and
general neurological examination was within normal.
His Ophtha-ENT examination demonstrated the following.
Visual acuity was 20/100 OD and 20/20 OS (OD is right
eye; OS is left eye). The pupils were equal and reactive
bilaterally. The extraocular muscles of the left eye were
intact but the patient was unable to look up on the right
and experienced diplopia with attempts to do so.
There was the presence of confluent bleeding covering
the right half of the eye over the sclera and beneath the
conjunctiva on the right side, and on ophthalmoscopic
examination there is a pool of blood in the anterior
chamber of the right eye covering the iris and extending
up to the inferior aspects of the pupil (but not occluding).
There is pain to palpation of the bony infraorbital margin,
yet hypoesthesia exists in the infraorbital region extending
down towards the cheek. In a darkened room a physician
places a flashlight over the cheek and notes that light
transilluminates the left maxillary sinus but not the right. On
CT Scan the right side notes that orbital fat has prolapsed
into the maxillary sinus and seems to be joined by a
prolapse of the inferior rectus muscle.
STUDENT QUESTIONS

● GIVE THE ANATOMICAL BASIS FOR THE FINDINGS AND

SYSMPTOMS OF THIS CASE. Visualize the presentation of the
patient at the ER.

● Briefly define and discuss the following and explain why

these were examined:

• Visual acuity, pupillary reflexes, diplopia

• Ophthalmoscopic Examination
• Transillumination test done on the patient

● What are the bones that form the orbital cavity? Why
has the floor of the orbital cavity fractured?

● What are the extraocular muscles? Why is the patient

unable to look up?

● What is the blood supply to the eye? What is a

subconjunctival hemorrhage?

● What is a hyphema?

● What is the likely diagnosis and why? (FINAL DIAGNOSIS)

● What is best treatment or management in this case?

What are the possible complications if left untreated?

HERE ARE THE INSTRUCTIONS FOR YOUR SGD SESSION:

• Study the module on the Eye and the Orbit

• Dissect this case and answer the above questions
• Prepare your individual ppt presentation
• Submit your individual ppt presentation in the
NEUVLE SGD SUBMISSION PORTAL Mar 15 (8am)
• Be ready to be grouped at random during the Lab
Session on March 15
• Collaborate with your groupmates for your subtopic
• Interact with the group during the SGD session
• Await comments and observations from your
faculty proctor. He/She may ask further questions.
• Check grade given via NUEVLE.

END.