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Eye

  • Jennifer V. Huang
  • Apichaya Monsomboon
Chapter

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].

Keywords

Ocular ultrasound Retinal detachment Globe rupture Elevated intracranial pressure Vitreous hemorrhage Lens subluxation Intraocular foreign bodies 

Supplementary material

Video 10.1

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)

Video 10.2

Retinal detachment: this video demonstrates a transverse view of the above retinal detachment. Video courtesy of Mikaela Baker (MP4 2941 kb)

Video 10.3

Vitreous detachment and hemorrhage: this is a video of the above vitreous hemorrhage and vitreous detachment. Video courtesy of Mikaela Baker (MP4 1324 kb)

Video 10.4

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)

Video 10.5

Papilledema: this video demonstrates papilledema and hypoechoic fluid within the optic nerve sheath. Video courtesy of Jennifer Huang (MP4 161 kb)

Video 10.6

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)

Video 10.7

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)

Video 10.8

Periorbital cellulitis: this video of the eye demonstrates periorbital cellulitis. Image courtesy of Jennifer Huang (MP4 181 kb)

Video 10.9

Periorbital cellulitis and abscess: this video demonstrates periorbital cellulitis with an abscess. Image courtesy of Jennifer Huang (MP4 184 kb)

References

  1. 1.
    Roque PJ, Hatch N, Barr L, Wu TS. Bedside ocular ultrasound. Crit Care Clin. 2014;30(2):227–41.CrossRefPubMedGoogle Scholar
  2. 2.
    Blaivas M, Theodoro D, Sierzenski PR. A study of bedside ocular ultrasonography in the emergency department. Acad Emerg Med. 2002;9(8):791–9.CrossRefPubMedGoogle Scholar
  3. 3.
    Vrablik ME, Snead GR, Minnigan HJ, Kirschner JM, Emmett TW, Seupaul RA. The diagnostic accuracy of bedside ocular ultrasonography for the diagnosis of retinal detachment: a systematic review and meta-analysis. Ann Emerg Med. 2015;65(2):199–203.e1.CrossRefPubMedGoogle Scholar
  4. 4.
    Fielding JA. The assessment of ocular injury by ultrasound. Clin Radiol. 2004;59(4):301–12.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Jennifer V. Huang
    • 1
  • Apichaya Monsomboon
    • 1
  1. 1.Department of Emergency MedicineIcahn School of Medicine at Mount SinaiNew YorkUSA

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