This article appears in the February issue of JAAPA.
It’s 6:15 p.m. and the after-hours care center is hopping. I’ve just finished up with the 18th patient of the evening—another youngster with cough and cold—when the nurse hands me the encounter form for the next patient. “He was hit in the eye with a Nerf dart,” she says. Then in a whisper she adds: “It was fired by his father.”
I step into the exam room to find a young adolescent boy sitting quietly on the exam table. His mother reclines in one of the chairs nearby.
“I understand you were hit in the eye by a Nerf dart,” I say. “How are you doing?”
“I can’t see out of my eye,” the boy says. “Everything is blurry.”
“Are you in a lot of pain?”
The boy shrugs his shoulders. “It hurts,” he says.
I pull the otoscope from my pocket and pass the light across the surface of the boy’s left eye. He winces a bit when the light strikes the cornea. The pupil does not react. The lower half of the anterior chamber is flooded with blood.
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