Orbital

This was from a 52 year old male with a recent surgical history of vitreous detachment that became a retinal detachment. He presented to the emergency room for vision changes in same eye after an object fell and hit his head. Ocular ultrasound was performed at the bedside which revealed a new vitreous detachment. Important to note here that it is crucial to fan/tilt through the entire eye, making sure to visualize the optic nerve in order to differentiate between a vitreous and retinal detachment. In this case, notice how the lesion spotted in the chamber does not connect to the optic nerve, which is consistent with a vitreous detachment.

Dr. Christopher Paulo, DO, PGY-1

Riverside Regional Medical Center Emergency Medicine Program (Newport News, VA)

This is from a 63 year old female who initially presented to the emergency department with vision loss over the last 24 hours. She reported bending over when she experienced complete vision loss from one of her eyes. Point of care ultrasound was performed, locating the optic nerve, but more interestingly a hyperechoic structure within the nerve (spot sign).

Overall, this is was suggestive of a central retinal artery occlusion. In this sort of situation, color doppler can also be utilized to assess for arterial versus venous occlusion.

Dr. Christopher Paulo, DO, PGY-1

Riverside Regional Medical Center Emergency Medicine Program (Newport News, VA)

This is a clip from a patient presenting with foreign body sensation. They had a piece of metal hit their eye a week ago. Previously seen for complaint but told no foreign body seen on exam.

On ultrasound clip a hyperechoic structure can be seen adjacent to the globe. Note that with dynamic eye movements the foreign body does not move suggesting this is outside of the globe.

Image courtesy of Robert Jones DO, FACEP @RJonesSonoEM

Director, Emergency Ultrasound; MetroHealth Medical Center; Professor, Case Western Reserve Medical School, Cleveland, OH

View his original post here