OCULAR Ultrasound by dr luke Philips
FACEM, MBBS, BSC(BIOMED)(HONS), CCPU
EMERGENCY CONSULTANT - ALFRED HEALTH
CO-DIRECTOR OF EMERGENCY MEDICINE TRAINING (THE ALFRED HOSPITAL
CO-CHAIR OF THE EMERGENCY MEDICINE ULTRASOUND GROUP BOARD OF DIRECTORS
75yo Female presents to the ED with sudden onset right visual loss.
I took over from overnight staff and reviewed the patient in the morning. A point of care ocular ultrasound was performed.
The Ultrasound demonstrates a macular off rentinal detachment. The thick undulating hyperechoic membrane in the posterolateral globe is always attached to the optic nerve posteriorly & the ora serrata anteriorly – Almost like a towel pegged on each end to a clothes line. The differential diagnosis is a vitreous detachment which tends to be more mobile, less uniform and is not attached to the optic nerve.
Ultrasound has a 97-100% Sensitivity for detecting retinal detachment & is 83-100% Specific in a recent meta-analysis. Use as a rule in test. If not visualised you may need to investigate further by dilating the pupil and looking at the retina with opthalmoscope or pan-optoscope.
The Time to diagnosis after I saw the patient was less than 10 minutes and the patient was referred for an urgent ophthalmology opinion.
How to Perform an Ocular Ultrasound
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