|Year : 1983 | Volume
| Issue : 5 | Page : 495-498
Role of ultrasonography in ocular trauma
IM Bhatia, A Panda, Y Dayal
Dr. Rajendra Prasad Centre for Ophthalmic Sciences A.I.I.M.S., New Delhi, India
I M Bhatia
Dr. Rajendra Prasad Centre for Ophthalmic Sciences A.1 I.M.S., New Delhi-110029
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Bhatia I M, Panda A, Dayal Y. Role of ultrasonography in ocular trauma. Indian J Ophthalmol 1983;31:495-8
Ultrasonography is a valuable tool in the diagnosis of posterior segment pathologies particularly when the media has become opaque as it can visualize and localize the position of the lesions which would not be possible by any other means. As a diagnostic tool its potential value compares well with that of the Ophthalmoscope. , It can detect the presence of ocular or orbital foreign bodies of any kind when the radiological investigation become negative.
More than two decades have passed since the early reports on the clinical usefulness of ultrasound in the diagnosis of ocular and orbital pathologies appeared in the literature. However, there is hardly any report available from India projecting its diagnostic potential.
The principal object of this paper is to describe the experiences with A and combined A and B scan ultrasonography in the evaluations of posterior segment lesions as well as to show the representative scans of these lesions in cases of ocular trauma. This precise information was indeed unobtainable by any other modality due to the problems posed by the opaque media.
| Materials and Methods|| |
This study describes the findings in 100 cases of ocular trauma on account of varied causes in which the media had become opaque due to different pathological lesions, such as corneal scar, hyphaema, cataract and vitreous haemorrhage operating either alone or in combination thus rendering the assessment of associated lesions of the posterior segment impossible.
All the cases were subjected to A scan using Kretz Technic machine as well as combined A and B scan ultrasonograph using extremely sensitive coloeman's ultrasonographic machine.
Ultrasonography could delineate pathological lesions in the posterior segment in as high as 21% of the cases. Out of these three cases revealed multiple lesions. Immersion as well as direct contact methodologies were employed while using Kretz technique machine for A-scans. Methyl cellulose was used as a coupling agent in the direct contact method.
While operating colemans combined A and B Scan machine, immersion bath was utilised to get the requisite scans.
The various types of pathological lesions which could be diagnosed ultrasonographically are shown in [Table - 1]. Different pathological lesions detected are documented in [Figure - 1][Figure - 2][Figure - 3][Figure - 4][Figure - 5].
This procedure was able to bring the dream of visualising the obscure pathologies into the realm of reality. Thus varied complex pathological entities as well as intraocular foreign bodies could be diagnosed and localised accurately.
| Discussion|| |
Ultrasonography is comparatively a newer diagnostic procedure which has been added with considerable advantage to the already existing impressive list of diagnostic armamentarium available to the ophthalmologist.
Not only the nature of the lesions but also the exact dimension of the globe can be known precisely. Again the procedure is repeatable and without any hazards whatsoever.
The most frequent findings recorded ultrasonically amongst the group under consideration was that of organised vitreous membrane. The various other changes which could be detected were retinal detachment, vitreous haemorrhages and intraocular foreign bodies. The vitreous veil and dislocated lens simulated the retinal detachment. However, the features which helped to differentiate them accurately are mentioned below.
1. The lesions could not be traced serially to to the optic disc.
2. The echo could be eliminated by reducing the gain of B-Scan received.
3. Simultaneous use of A-Scan could also easily differentiate the vitreous veil from a true detachment by means of quantification of the relative echo heights. The retinal echo was always of higher or equal amplitude to the choroid, whereas the vitreous fibrin echoes were always found to have lesser amplitude. Next to vitreous membrane retinal detachment was the commonest lesion detected ultrasonically. Three of the cases of detachment were associated with either vitreous pathology or intraocular foreign body.
Presence of varied types of foreign bodies in the eye produced an echo of very high amplitude. Ultrasonic detection and localization of foreign bodies was far more easier and quicker wherever prior radiographic identifications was possible. In case of non radio opaque intraocular foreign body with hazy media ultrasonography provided us with the only means of detecting and localizing the same. Thus this diagnostic procedure was found to be extremely useful in delineating various pathological changes of the globe in patients of ocular trauma. This enabled us to treat these conditions both medically and surgically on a more rational basis.
| Summary|| |
100 cases of ocular trauma having hazy or opaque media due to varied causes were subjected to ultrasonography both A and B scans to detect the pathological lesions if any in the posterior segment.
In as many as twenty one patients one could demonstrate various pathological lesions like vitreous membranes, retinal detachment, vitreous haemorrhages, dislocated lenses and intraocular foreign bodies in spite of the media being opaque.
Ultrasonography not only helped in detection but also in the localization of both radio-opaque and non-radio opaque intraocular foreign bodies. Similarly extent of the retinal detachment could be precisely delineated. Ultrasonographic information made it possible to treat these patients both medically and surgically on a more rational basis.
| References|| |
Jackson Coleman, Robert L. Jack and Louise A. Frauzen, American Jour. Ophthal., 75, 279, 1973.
Gilbert Baum, Trans. American Ophthalmol., Otolaryng., 68, 265, 1964.
[Figure - 1], [Figure - 2], [Figure - 3], [Figure - 4], [Figure - 5]
[Table - 1]