Child with eye trauma and hyphema; cannot tolerate examination; action?

Child with eye trauma and hyphema; cannot tolerate examination; action?

• A. Refer the child immediately to an ophthalmologist
• B. Administer an oral analgesic
• C. Apply a Fox shield and reevaluate in 24 hours
• D. Instill anesthetic eyedrops

Answer: (A)

The priority is urgent specialist assessment. Hyphema after trauma can hide serious intraocular injuries and can lead to complications like increased intraocular pressure or occult globe damage, especially when the child cannot cooperate for a full exam. An ophthalmologist can safely evaluate the eye, measure pressure, look for behind-the-eye injury with appropriate imaging if needed, and initiate definitive management. In the meantime, protect the eye with a rigid shield to prevent further injury and avoid delaying care or attempting to examine with uncooperative technique or topical anesthetics.

The priority is urgent specialist assessment. Hyphema after trauma can hide serious intraocular injuries and can lead to complications like increased intraocular pressure or occult globe damage, especially when the child cannot cooperate for a full exam. An ophthalmologist can safely evaluate the eye, measure pressure, look for behind-the-eye injury with appropriate imaging if needed, and initiate definitive management. In the meantime, protect the eye with a rigid shield to prevent further injury and avoid delaying care or attempting to examine with uncooperative technique or topical anesthetics.