A 7-Year-Old Girl Is Brought to the Emergency Department with a Painful

question 355

Multiple Choice

A 7-year-old girl is brought to the emergency department with a painful swollen eye.  She awoke this morning with left eye swelling, which has progressively worsened throughout the day.  The patient has seasonal allergies for which she takes an over-the-counter antihistamine.  She has no other significant medical history.  Temperature is 39.1 C (102.4 F) .  Examination of the left eye shows tender, swollen, erythematous eyelids and a small abrasion below the eyelid.  There is mild conjunctival injection but no drainage.  Extraocular movements are normal and do not cause pain.  Visual acuity is 20/20 bilaterally.  Funduscopic examination is normal, and examination of the right eye is unremarkable.  Facial sensation is intact.  Which of the following is the most likely diagnosis in this patient?

• A)Allergic conjunctivitis
• B)Anterior uveitis
• C)Bacterial conjunctivitis
• D)Cavernous sinus thrombosis
• E)Optic neuritis
• F)Orbital cellulitis
• G)Preseptal cellulitis

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