![]() The More Common Pathologies Evaluated with POCUS ĭuker JS, Kaiser PK, Binder S, et al. Increase gain to better visualize abnormalities within vitreousĭynamic exam: have patient look side to side Turn down the gain to evaluate optic nerve (& structures posteriorly) Stabilize hand on pt’s face to control amount of pressure applied. Linear probe (high frequency), probe marker to patient rightĬover eye with tegaderm (remove air bubbles)Īpply a lot of gel. May see swelling of optic disc swelling, distended optic nerve sheath, retinal detachment ![]() Immunomodulators if indicated įluid in Tenon capsule -> pathognomonic “T sign” (fluid in the posterior episcleral space on both sides of the optic nerve and extending around optic nerve). Treatment: NSAIDs -> steroids (topical vs systemic). May have scleral edema, erythema, violet-bluish hue if anterior.Ĭomplications: vision loss (particularly if posterior) Types: Anterior(more common) vs posterior (less common but thought to be underdiagnosed)ĭetermined by location relative to the extraocular rectus musclesĪssociations: more common in females and most often associated with autoimmune disorders, though may also be infectious or trauma/surgically inducedĬlinical presentation: eye pain worse with movement. What is it? Inflammation and edema of the sclera Hyperechoic membrane within the vitreous that’s less mobile with dynamic exam compared to retinal or vitreous detachment due to traction on the retina. Management: observation, intraocular enzyme injection, may require vitrectomy. Ultrasound useful for identifying partial posterior vitreous detachment. ĭiagnosis: optical coherence tomography (OCT) is standard. Symptoms: usually insidious & may include blurred/reduced/altered vision, scotoma, metamorphopsia, micropsia. Complete vitreous detachment reduces the risk. Risk Factors: diabetes, diabetic retinopathy, hypertension, sickle cell, eye surgery, vitreous hemorrhage, retinopathy of prematurityĬomplications: potential for retinal detachment and vision loss. However, the majority of cases are concurrent VMT (associated with diabetic retinopathy or macular edema, age-related macular degeneration, other macular diseases) and the prevalence & incidence are much higher Slightly more common in female, no predilection for age or race. Pathophysiology: fibrocellular proliferation of glial cells, macrophages, and fibrocytes at the vitreoretinal interface. What is it? -> Incomplete posterior vitreous detachment (PVD) leading to multiple tractional forces at the vitreo-retinal/macular interface, resulting in morphologic changes and often functional effects Once glucose levels improved, he was discharged home with close follow up. Also requested initiating inflammatory/rheumatologic workup. They recommended outpatient ophtho follow up and a course of topical steroids and cycloplegics, along with NSAIDs, in the meantime opted against systemic steroids until diabetes was better controlled. They performed comprehensive exam including dilated fundal assessment and diagnosed “ vitreo-retinal traction bands forming an almost complete napkin ring” + diffuse (anterior + posterior) scleritis. The membranes are also less mobile than typical retinal detachment with dynamic exam.ĭiffuse scleral thickening, seen anteriorly as well as posteriorly which, along with clinical presentation, was suggestive of scleritis.Ĭase continued : Ophthalmology was consulted. This was concerning for but different-appearing than typical retinal detachment. There appear there to be multiple attachment points posteriorly, some near the optic nerve. Hyperechoic linear membranes extending from anterior to posterior globe on both medial and lateral aspects.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |