Point-of-Care Ultrasound Findings in a Case of Orbital Cellulitis: A Case Report

Abstract

Ophthalmologic complaints are common in the emergency department. The utility of point-of-care ultrasound (POCUS) as an accessible, noninvasive modality to evaluate ocular pathology is of great value-particularly in settings where resources are limited or where ophthalmologic consultation may not be readily available. A 21-year-old woman presented to the emergency department with periorbital edema, erythema, and drainage that was worsening despite topical and oral antimicrobial therapy. Mild proptosis was present on examination. POCUS was performed to investigate her symptoms further. A modified ocular ultrasound revealed prominence and edema of the retro-orbital soft tissue with echogenic fat, consistent with the diagnosis of orbital cellulitis. These findings were corroborated with computed tomography imaging. Why Should an Emergency Physician Be Aware of This?: Few reports describe the utility of POCUS in evaluating patients for orbital cellulitis. This case emphasizes the value of POCUS in assessing patients presenting to the emergency department with ocular complaints and demonstrates ultrasound-specific findings that may lead the clinician toward the diagnosis of orbital cellulitis. © 2021 Elsevier Inc.