A 30-year-old man presents 4 hours after sustaining a superficial corneal abrasion from a tree branch. Anterior chamber is formed and quiet. On slit-lamp examination, the wound appears shallow and self-sealing. Which investigation is MOST appropriate to rule out a small, occult full-thickness corneal laceration before deciding on conservative management?

• A B-scan ultrasonography to assess posterior segment
• B CT orbit (thin sections, 1 mm) without contrast
• C Seidel test under cobalt blue light after fluorescein application ✓
• D Applanation tonometry to confirm normal intraocular pressure

Explanation

The Seidel test is the bedside investigation of choice to detect occult full-thickness corneal or scleral wounds. A thin strip of fluorescein is applied; aqueous leakage dilutes the dye and produces a streaming or rivulet pattern under cobalt blue light. It can detect a wound leaking even minimal aqueous. CT orbit detects IOFBs but does not confirm wound patency. Tonometry is contraindicated in suspected globe injury. C-scan assesses the posterior segment, not wound integrity.

Reference: Parson's Diseases of the Eye, 23rd ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.