Ocular Ultrasound

Ocular ultrasound has multiple uses today: structural assessment in ocular trauma, prediction of intracranial hypertension, diagnosis of retinal detachment, retinal artery occlusion, foreign body, etc.

Technique
The patient remains with the eyes closed, a copious amount of gel is applied to optimize contact, and with the linear transducer.

Current Uses of Ultrasound
1. Trauma
- CONTUSOUS TRAUMA:

• Anterior segment:
Hyphema
Waterfall.
Lens (sub) luxated.
Posterior capsule rupture.
• Posterior segment:
Hemovitreous.
Retinal tear.
Retinal detachment.
Retinochoroidal edema.
Posterior scleral rupture.
- PENETRATING TRAUMA:
• Anterior segment:
Hyphema
Narrowed anterior chamber.
Capsular rupture.
• Posterior segment:
Hemovitreous (posterior vitreous detachment –VD–).
Posterior scleral rupture.
DR.
Hemorrhagic DC.
2. Foreign bodies
It is useful in the detection of foreign bodies in 95% of those located in the globe and in 50% of those located in the orbit. The foreign body presents as a hyperechoic focus with posterior artifact or shadow.
3. Surgical
It is used in the postoperative follow-up of the following entities:
Endophthalmitis
Expulsive hemorrhage.
Macular edema
Sympathetic ophthalmia.
Intraocular lens and cataract remains in the vitreous cavity.
Cerclages.
Gas, silicone, air.
4. Vitreoretinal pathology
The most frequent indication in ophthalmology is the presence of media opacity.
5. Intraocular tumors
We resort to ultrasound even though there are transparent means to assess their dimensions, progression and regression after treatment.
It detects tumors with a minimum size of 0.8 mm.
Currently, its use is being displaced by ultrasonic biomicroscopy in iris tumors and in choroidal tumors, ultrasound scanners with 20 mHz probes and 3D ultrasound scanners provide greater precision.
The use of ultrasound in the follow-up of choroidal nevus should be highlighted, as well as its differential diagnosis with melanoma, one of the tumors most frequently detected by this technique.
In retinoblastoma it should be the initial diagnostic method, since its diagnostic reliability is very high since it can detect masses smaller than 2 mm and the presence of calcifications in up to 85-90%.
In addition, its harmlessness must be added both due to the total absence of ionizing radiation and because it is performed without any type of sedation of the patient.