Conjunctival and Adnexal Disease

Abstract

Many adnexal structures are accessible to examination by ultrasound biomicroscopy. In general, any structure that can be approached over the surface can be examined. An eye cup of the same design used for examination of the globe can often be used. For example, an eyelid lesion can usually be examined by placing the eye cup on the surface of the lid, applying light pressure, and filling with 2.5% methyl cellulose. Viscous solutions such as 2.5% methyl cellulose are required during this type of examination to minimize fluid loss during examination. Occasionally a water bath constructed with a surgical drape may be required because of the irregularity of the surfaces being examined. A small amount of pressure from a cotton swab may be necessary to bring pathology into a position in which it can be examined. This is often true of lid margin tumors and lateral fornix tumors, where some lid eversion may be required. The keratinized epithelium of the skin causes significantly more attenuation than conjunctiva or cornea and limits the penetration over skin surfaces.