Novel Application of Point-of-Care Ocular Ultrasound in a Left Central Retinal Artery Occlusion

Abstract

Bridwell et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Detection of Central Retinal Artery Occlusion by Point-of-Care Ultrasound in the Emergency Department: A Case Series

“…It also allows earlier initiation of stroke work-up [4,6,7]. Various cases have been described that similarly point to the efficacy of POCUS as a diagnostic tool for emergency physicians [1,6,[8][9][10]. It is efficient, portable, non-invasive, and well-tolerated [10,11].…”

“…It is efficient, portable, non-invasive, and well-tolerated [10,11]. Prior to the integration of POCUS workup of CRAO consisted mainly of direct fundoscopy; this required direct visualization of the intraocular structures and pupillary dilation [1]. This is potentially concerning since the skills to detect abnormalities reliably by fundoscopy performed by ophthalmologists and non-ophthalmologists are reportedly declining [12].…”

“…This is potentially concerning since the skills to detect abnormalities reliably by fundoscopy performed by ophthalmologists and non-ophthalmologists are reportedly declining [12]. Other standard of care tests include visual acuity testing, evaluation for afferent pupillary defect, slit-lamp examination, and fluorescein angiography and ophthalmology consultation [1,2]. POCUS has been shown to be an effective tool for diagnosing other ocular emergencies, like retinal detachment, vitreous hemorrhage, and vitreous attachment [13,14].…”

“…Central retinal artery occlusion (CRAO) is a rare, but vision-threatening event that requires prompt diagnosis [1]. Risk factors include hypertension, diabetes, atherosclerotic disease, and smoking with greater incidence in men and with increasing age [2].…”

“…Risk factors include hypertension, diabetes, atherosclerotic disease, and smoking with greater incidence in men and with increasing age [2]. Standard diagnosis relies on visual acuity testing, relative afferent pupillary defect evaluation, fundoscopic exam, and fluorescein angiography [1,2]. These methods, although effective, are time-consuming, resource-dependent, and many times ophthalmologist-dependent [3].…”