EMT here with a question about a recent 911 call with a eye injury
Hello, I understand if this needs to be removed as I am not a professional directly related to eye care, but I do practice emergency healthcare as an EMT and would like possible thoughts on an eye injury patient I recently treated and transported.
I was called to a skilled nursing facility for patient with something in her eye. We arrived to find 51/F with extensive hx of glaucoma, htn, diabetes, back injuries, etc, that is mostly blind at baseline. Patient is bed bound due to paraplegia for the last 6 years. Staff states they found her eye to be red and teary a couple hours ago and believe there is something in her eye.
Upon EMS exam her eye appears mildly moist and weepy with clear liquid ,the sclera is completely red, the cornea appears cloudy overall with a completely blown out pupil, no light reaction, and the globe is SIGNIFICANTLY sunken in from the cornea inward. The shape of her eye is like a ping pong ball that has been dented at the upper aspect of the cornea in to be %70 the size of a normal eye ball. Other eye appears normal in shape, but also cloudy.
Patient is completely alert and oriented, but doesn't really understand what is happening. Vitals are hr 80, 104/61, resp 14, spo2 100/RA. Patient complains of 7/10 pain, not worse on movementand she appears to be able to move the eye. She cannot see from the eye, when she normally has some vision. Says pain is spreading into her temple now and she cannot control the tearing.
Patient states she was rolling yarn all day and felt like she may have get something in the eye as it started to feel weepy. She rubbed the eye to find it to be very moist. Patient denies trauma, but we have no idea what could have caused the injury. Eye specialist is too far away so we transported to trauma facility w/o trauma alert as local hospital refused without known mechanism of injury. Patient was stable and pleasant throughout transport.
Around six years ago patient had an eye surgery at the specialist eye hospital to correct the glaucoma, but states there were complications that lead to her being trached and eventually leading to her paraplegia. Details are not clear about that...
My questions are; What was I even seeing? What could have caused this/ spontaneously caused this?
I had no reason to check it at the time but was told her bgl was 250 earlier in the day but that is normal for her. She had no signs of dka, but someone told me that dka can increase inter-eye pressure. Is that possibly a cause?
Is there anything else I could have done?
Thanks for any help.