Case Resolution
So what about the 65-year-old man with acute vision loss? After performing your funduscopic exam, you bring the ultrasound bedside and scan your patient’s eye. You immediately notice a retinal detachment and call the ophthalmologist, who is able to see the patient immediately in her office. On the way out, your patient thanks you for your quick diagnostic skills.
Explore This Issue
ACEP Now: Vol 38 – No 03 – March 2019Ocular ultrasound is easy to learn and can rapidly assess ocular emergencies. With practice, you can easily incorporate POCUS into your diagnostic algorithm and rule in or out important ocular pathology.
Part 2 will appear in the April issue.
References
- Lizzi F, Coleman DJ. History of ophthalmic ultrasound. J Ultrasound Med. 2004;23(10):1255-1266.
- Lyon M, Blaivas M. Ocular ultrasound. In: Emergency Ultrasound. 2nd ed. New York: McGraw Hill; 2008: 449-462.
- Jacobsen B, Lahham S, Lahham S, et al. Retrospective review of ocular point-of-care ultrasound for detection of retinal detachment. West J Emerg Med. 2016;17(2):196-200.
- Blaisvas M, Theodoro D, Sierzenski PR. A study of bedside ocular ultrasonography in the emergency department. Acad Emerg Med. 2002;9(8):791-799.
- Vrablik ME, Snead GR, Minnigan HJ, et al. The diagnostic accuracy of bedside ocular ultrasonography for the diagnosis of retinal detachment: a systemic review and meta-analysis. Ann Emerg Med. 2015;65(2):199–203.e1.
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One Response to “High-Yield Ocular Ultrasound Applications in the ED, Part 1”
March 25, 2019
Thomas Benzoni, DO“Contraindications to the exam include high suspicion of globe rupture.”
This is a common misunderstanding.
In fact, trauma and suspicion of ruptured globe is one of the tremendously positive indications for ultrasound.
I make here an assumption that you suspect trauma or rupture and that you know not to put pressure on the globe. But that is the great thing about U/S: more goop and stand off a bit. You’ll have 0 pressure.
Compare that to any touching the eyelid to say nothing of retracting the lid.
You’re looking for obvious rupture/non-round structure.
Let’s myth-bust and use U/S to diagnose globe rupture.