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A 36-year-old man presented with sudden onset pain and blurry vision in his left eye of two hours duration. Recent trauma was denied. Ophthalmic examination revealed a luxated left globe with retracted upper and lower eyelids, severely restricted extraocular movements, visual acuity 20/60 OS and swollen optic disc with raised margins on fundoscopy. After instructing the patient to maintain a constant downward gaze, topical anaesthetic was applied to the globe. The upper eyelid was retracted and gentle pressure was applied to the superior scleral surface to reposition the globe. One hour later visual acuity was 20/30 OS, extraocular movements and fundoscopic examination returned to normal. Thyroid workup was unremarkable. Spontaneous globe luxation is a rare condition characterised by globe displacement anteriorly beyond the orbital rim and is known to occur in thyroid ophthalmopathy, previous trauma as well as being reported with floppy eyelid syndrome and shallow orbits.1
This article has been adapted from Dhawan Saurabh S, Shammas Carlos R. Spontaneous globe luxation Emergency Medicine Journal 2008;25:309
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