
A 17-year-old boy presents with a tennis ball injury to the right eye, which occurred 6 hours earlier during a game of road hockey. He complains of severe pain in and around the eye, as well as blurred vision and photophobia. He is otherwise healthy. On examination, visual acuity is 6/30 in the right eye and 6/6 in the left eye. Extraocular movements, confrontation visual fields, and pupillary responses are normal. Tonometry reveals intraocular pressures of 35 mm Hg in the right eye and 11 mm Hg in the left eye. Anterior segment examination of the right eye reveals the image above.
The most likely diagnosis is
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Hypopyon
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Hyphema
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Acute angle-closure glaucoma
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Subconjunctival hemorrhage
Answer on page 321
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