Eyelid disorders Quiz: Ace Your Exams
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A 53-year-old man presents to the primary care physician for persistent left eyelid swelling. The patient states he accidentally bumped his eye on a doorframe one week ago, resulting in a small abrasion that subsequently became increasingly swollen, red, and painful. His primary care physician examined him two days ago, prescribed cephalexin, and instructed him to return if his symptoms worsened. Today, he returns for new pain with eye movements and blurry vision in the left eye. He has been taking his antibiotics as prescribed. The patient has a history of diabetes, hypertension, and hyperlipidemia for which he takes amlodipine, atorvastatin, and metformin. He drinks socially and does not use tobacco products. His temperature is 38.5°C (101.3°F), blood pressure is 120/60 mmHg, pulse is 101/min, respiratory rate is 18/min, and oxygen saturation is 99% on room air. On physical examination, there is evidence of marked peri-orbital erythema and swelling. There is tenderness to palpation of the left upper eyelid and chemosis of the left eye. Extraocular movement causes pain. Visual acuity is decreased in the left eye compared to the right. Which of the following is the best next step in management?
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