Abstract
Point-of-care ocular ultrasound can be used to rapidly identify potential vision-threatening ocular emergencies in the emergency department [1]. Because the globe is a fluid-filled structure, it provides a perfect medium for ultrasonography. Direct visualization of the anterior and posterior chambers of the globe, as well adjacent structures, are easily identified with ultrasonography, even when the eyelids are swollen shut. Ocular ultrasound is a safe, non-invasive and well-tolerated adjunct to the physical eye exam that can be performed quickly at the bedside. It is a valuable tool that can be used to evaluate various ocular emergencies including retinal detachment [2], vitreous hemorrhage, lens subluxation, globe rupture, intraocular foreign bodies [3], and elevated intracranial pressure [4].
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References
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10.1 Electronic Supplementary Material
Normal transverse: obtain transverse views of the globe by scanning superiorly and inferiorly. This video demonstrates a normal superior-inferior sweep through the transverse view of right eye. Video courtesy of Jennifer Huang (MP4 2932 kb)
Retinal detachment: this video demonstrates a transverse view of the above retinal detachment. Video courtesy of Mikaela Baker (MP4 2941 kb)
Vitreous detachment and hemorrhage: this is a video of the above vitreous hemorrhage and vitreous detachment. Video courtesy of Mikaela Baker (MP4 1324 kb)
Vitreous hemorrhage: this video of the eye demonstrates echogenic material in the posterior chamber consistent with vitreous hemorrhage. Video courtesy of Mikaela Baker (MP4 894 kb)
Papilledema: this video demonstrates papilledema and hypoechoic fluid within the optic nerve sheath. Video courtesy of Jennifer Huang (MP4 161 kb)
Pupillary light reflex: this video demonstrates the consensual pupillary light reflex. This technique can be used when the eyelids are too swollen to open the eye and examine the pupils. Ask the patient to look downward. Gently place the probe on the upper eyelid with probe marker pointing toward the patient’s right. To obtain a coronal view of the eye through the iris, flatten the angle the probe toward the patient’s forehead. Once you identify the pupil, shine a light into the other eye, and observe the pupillary light reflex in the affected eye on ultrasound. Video courtesy of Errel Khordipour (MP4 3288 kb)
Foreign body: this video demonstrates a small metal foreign body on the surface of the cornea on the left side of the anterior chamber. Video courtesy of Errel Khordipour (MP4 1683 kb)
Periorbital cellulitis: this video of the eye demonstrates periorbital cellulitis. Image courtesy of Jennifer Huang (MP4 181 kb)
Periorbital cellulitis and abscess: this video demonstrates periorbital cellulitis with an abscess. Image courtesy of Jennifer Huang (MP4 184 kb)
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Huang, J.V., Monsomboon, A. (2018). Eye. In: Nelson, B., Topol, E., Bhagra, A., Mulvagh, S., Narula, J. (eds) Atlas of Handheld Ultrasound. Springer, Cham. https://doi.org/10.1007/978-3-319-73855-0_10
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DOI: https://doi.org/10.1007/978-3-319-73855-0_10
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