A 35-year-old-patient presents following motor vehicle collision as a restrained passenger. The vehicle's dashboard was displaced into the cabin, causing prolonged entrapment of the patient’s lower extremities. The patient’s left thigh was noted by EMS to have an obvious deformity with bleeding from an anterior wound. A tourniquet was placed to the proximal left thigh. A deformity was also noted to the right thigh without obvious external hemorrhage…
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…3 days of floaters and “lightning bolt” white flashes in the temporal field of her right eye in the absence of eye trauma. She also reported right periorbital pain. She did not have blurry vision, diplopia, loss of vision, scalp tenderness, jaw claudication, fevers, chills, or weight loss. She denied photophobia despite wearing sunglasses in the Emergency Department. Her mother had died from choroidal melanoma, but the patient had not seen an ophthalmologist in 15 years.
Her uncorrected visual acuities were 20/60 OD and 20/40 OS. Intraocular pressure, pupillary reaction, and extraocular movements were normal. Point of care ultrasound (POCUS) revealed three hyperechoic, solid lesions with posterior acoustic shadowing in her right eye….
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