Thursday, May 23, 2013

Grit

A 60 year old woman undergoes a multi-level lumbar discectomy for lumbar spinal stenosis. The surgery goes as expected and the patient is brought to the post-anesthesia care unit. In recovery, the patient starts complaining of severe left eye pain. "I can't open my eye," she says, "because it feels like grit or sand is in it." Her visual acuity is roughly baseline. A fluorescein stain is shown below.
Challenge: What's your diagnosis?

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6 comments:

sibogox said...

sounds like corneal ulceration.

sibogox said...

or abrasion

Alex said...

herpes keratitis?

sid said...

Exposure keratitis from improper eye-closure while under general anesthesia?

city said...

corneal abrasion. anesthesia probably forgot to tape her eyes shut

Craig Chen said...

yes - most of you got it - corneal abrasion
-
Grit

This is a corneal abrasion (or corneal epithelial defect), a common injury immediately post-op if a patient rubs her eyes.

Sources: UpToDate; Wikipedia.