Tear-drop Shaped Pupil
What do you think caused this? This 81 year old male with a past medical history of Alzheimer’s dementia, a-fib on coumadin and coronary artery disease presents to the emergency department via EMS after being punched in left eye at his rehab facility. History was obtained from wife secondary to the patient’s advanced dementia. She reports that this morning while her husband was at breakfast, another resident walked up to him and punched him in the left eye. She did not witness the event. It is unknown if there was a loss of consciousness. She reports that her husband is already blind out of his right eye. Imaging confirmed globe rupture, no other traumatic injuries identified. The patient received IV ciprofloxacin for traumatic endopthalmitis prevention and his tetanus updated. He went to the operating room for globe repair with ophthalmology.