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A 7-Year-Old Boy Is Brought to the Emergency Department by His

question 1015

Multiple Choice

A 7-year-old boy is brought to the emergency department by his parents due to left eye swelling and redness. The patient has had left eye pain for 2 days and the pain worsened today. He has no symptoms in his right eye. He has allergic rhinitis, for which he takes intranasal steroids. The patient developed sinusitis approximately 3 weeks ago and was treated with amoxicillin-clavulanate. He has no other medical conditions and has had no surgeries. The patient's mother was diagnosed with left leg deep vein thrombosis after a recent transatlantic flight. Temperature is 39.2 C (102.5 F) , blood pressure is 102/70 mm Hg, pulse is 94/min, and respirations are 18/min. The left eyelid is erythematous, tender, and swollen. The conjunctiva is hyperemic. Movement of the left eye causes pain. Visual acuity and pupillary reaction are normal bilaterally. Purulent mucus is draining from the nose, and nasal turbinates are swollen and erythematous. Examination of the right eye is unremarkable, and facial sensation is intact. CT scan reveals inflammation of extraocular muscles, fat stranding, and mild anterior displacement of the globe. No fluid collections are identified. Which of the following is the best next step in management of this patient?

Definitions:

Visually Surprising

Something that is unexpected or startling from a visual perspective, often eliciting a strong reaction or attention.

Unwanted Contact

Interactions or communications that are undesired or uninvited, potentially causing discomfort or distress to the recipient.

Collectives

Groups or aggregates of people or items that share common features or are considered together.

Proximity

The physical or psychological closeness between people, which can influence attraction and relationship formation.