Jimmy, age 8, is brought to the clinic by his mother with right eye pain after falling on the playground. There is copious tearing and he has the lid tightly closed. When you attempt to exam him, he slaps at your hand and cries. His mother threatens him with spanking if he doesn’t hold still but this tact is futile. By this time he is crying loudly and evading you within the exam room by crawling on the floor and wrapping himself around his moms legs.What is the best way handle his behavior and discuss how you will deal with this situation. What diagnostic testing do you feel is the priority to initiate and most appropriate given the history?
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