Ocular Ultrasound



Figure 16.1
Patient position. Lean the patient’s head back and apply a copious amount of gel on top of a closed eyelid



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Figure 16.2
Normal ocular ultrasound. A normal eye will maintain its shape with a round cornea, anterior chamber, iris, lens, and posterior chamber. Adjust the depth to visualize the entire globe and optic nerve


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Figure 16.3
Optic nerve. The nerve is hypoechoic and will be flanked on both sides by its more hyperechoic sheath


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Figure 16.4
ONSD measurement. Measure the diameter 3 mm posterior to the optic disc




Ocular Pathology






  • Vitreous Hemorrhage



    • Extravasation of blood into the posterior chamber is most commonly due to posterior vitreous detachment (PVD), however, can be also be due to trauma or even be idiopathic


    • Appears as echogenic debris within the posterior chamber:



      • Can appear as layering of echogenic material posteriorly [2]


    • May only be visualized during dynamic eye imaging as swirling of echogenic debris while the eye is moving


    • Figure 16.5—Vitreous hemorrhage


    • Video 16.2—Vitreous hemorrhage


  • Retinal Detachment (RD)



    • Separation of the retina from the underlying epithelium.


    • Thick echogenic band posteriorly.


    • With dynamic eye movements, there will be little movement of the echogenic band, which will remain attached to an area near the optic nerve and the ora serrata [1]:



      • The attachment points help differentiate a retinal detachment from a posterior vitreous detachment.


    • Often associated with vitreous hemorrhage.


    • Figure 16.6—Retinal detachment.


    • Video 16.3—Retinal detachment.


  • Posterior Vitreous Detachment



    • Degenerative process in which the vitreous gel loses its attachment to the membrane.


    • Increase the gain to identify PVD, which will appear as a smooth, thin membrane and echogenic material within the posterior chamber.


    • With dynamic movements of the eye, echogenic material will swirl within the posterior chamber [2].


    • Can be confused with retinal detachment.



      • The retina will remain attached at the optic nerve or ora serrata.


    • Figure 16.7—Posterior vitreous detachment.


    • Video 16.4—Posterior vitreous detachment.


  • Retrobulbar Hematoma



    • A collection of blood posterior to the globe that appears hypoechoic compared to the surrounding tissue.


    • It can distort the globe due to pressure caused by the hematoma on the eye [1]


    • Figure 16.8—Retrobulbar hematoma


  • Lens Dislocation
Feb 27, 2018 | Posted by in ULTRASONOGRAPHY | Comments Off on Ocular Ultrasound

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