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Apparent Sudden Visual Loss: An Essential Approach
Published in Amy-lee Shirodkar, Gwyn Samuel Williams, Bushra Thajudeen, Practical Emergency Ophthalmology Handbook, 2019
B-scan: In cases of no fundal view, whatever the cause, it is imperative to perform B-scan ultrasonography to assess the integrity of the retina. This is a skill that all ophthalmologists in training should acquire. A vitreous haemorrhage for example will appear as a mobile reflective vitreous opacity (see Chapter 11 for further reading).
Posterior relaxing retinotomy
Published in A Peyman MD Gholam, A Meffert MD Stephen, D Conway MD FACS Mandi, Chiasson Trisha, Vitreoretinal Surgical Techniques, 2019
Stephen A Meffert, Gholam A Peyman
A comprehensive evaluation of the components of retinal traction is often possible in the preoperative examination. Meticulous indirect ophthalmoscopy with scleral depression is essential. B-scan ultrasonography is useful in patients with media opacity. Computed tomography is occasionally indicated in patients presenting after trauma to evaluate an intraocular foreign body, and may be helpful in assessing liquefaction of subretinal or suprachoroidal hemorrhage.16 Time spent in careful preoperative planning will be rewarded by efficiency in the operating room.
The eye and orbit
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
Intraocular foreign bodies must always be excluded when patients attend the accident and emergency department with an eye injury and a history of working with a hammer and chisel or a history of a potentially high-velocity injury. Radiography of the orbits must be performed. Ferrous and copper foreign bodies should always be removed, sometimes requiring the use of a magnet. B-scan ultrasonography can also assist in localising foreign bodies when a vitreous haemorrhage or cataract is present. CT can be used, but MRI is contraindicated if a ferrous intraocular foreign body is suspected.
A Case of Postoperative Endophthalmitis Caused by Streptococcus Bovis
Published in Ocular Immunology and Inflammation, 2023
Guangsen Liu, Yue Li, Lei Gao, Na Li, Jing Su
Discouragingly and surprisingly, the patient deteriorated dramatically the day after surgery, with visual acuity dropping to light perception. Corneal infiltration and edema were obviously aggravated (Figure 4). B-scan ultrasonography demonstrated dense vitreous opacities (Figure 2b). In addition, the patient developed an unexplained low-grade fever from 37.4°C to 38°C with WBC count was 10.49 × 109/L. There were no abnormalities observed in ultrasound scans of the abdomen. Blood cultures were obtained immediately and the results were negative. The patient was started on intravenous vancomycin 500 mg twice a day. In view of the deterioration condition, urgent vitreous fluid was obtained for culture again and empiric treatment was initiated with injection of 1 mg of vancomycin and 2 mg of ceftazidime into the vitreous body.
Upper Limit of Retinal Nerve Fibre Layer Thickness in Patients with Pseudopapilloedema
Published in Neuro-Ophthalmology, 2022
Varsha Pramil, Mary Tam, Laurel N. Vuong, Thomas R. Hedges
Recently, various studies have attempted to determine the most useful imaging modality in differentiation of pseudopapilloedema and papilloedema. For example, B-scan ultrasonography has been suggested as one of the best methods for diagnosing patients with pseudopapilloedema and specifically, patients with pseudopapilloedema and buried drusen.13,14 The cost-effectiveness of using B-scan ultrasonography to make a diagnosis before neuroimaging or additional invasive tests in patients suspected to have papilloedema has also been documented.15 Although B-scan ultrasonography has been shown to be useful, it is not available in all clinics and requires a trained technician.13,16 Unlike B-scan ultrasonography, OCT devices are widely available and easy to use. Because it is non-invasive and can be used as an initial test like B-scan ultrasonography, we can also assume that it would be as cost-effective. Additionally, EDI-OCT has been shown to provide unparalleled optic nerve head drusen visualisation and is able to differentiate pseudopapilloedema from papilloedema with high specificity and sensitivity.16–18
Morphologic ultrasonography of the temporal artery for diagnosis of giant cell arteritis: Brief report
Published in Modern Rheumatology, 2019
Chiara Posarelli, Rosaria Talarico, Andrea Passani, Marta Mosca, Marco Nardi, Michele Figus
The inclusion criteria for the case group included at least one of the following: an ESR of 50 mm/hour or more, new headache onset, jaw claudication, fever, polymyalgia rheumatica, temporal artery tenderness, and recent visual impairment. A 40 MHz B-Scan ultrasonography for each patient has been performed using an Eye Cubed’s 40 MHz (Ellex, Australia), by the same expert ophthalmologist. The ultrasound examiner was blinded to the diagnosis; the only person not blinded to the diagnosis was the rheumatologist. Eye Cubed’s 40 MHz (Ellex, Australia) is a machine routinely used by ophthalmologist to perform ultrasound biomicroscopy (UBM) of the anterior segment of the eye with an axial resolution of 23 microns and a lateral resolution of 33 microns, the image depth is 11.9 mm with a focal range from 10.5 to 14.5 mm. After identification of the pulse of the temporal artery the probe is placed in the temporal region (Figure 1) and it is possible to image the temporal artery (Figure 2).