Role of B-scan in Blunt Ocular Trauma: A Cross-sectional Study

Abstract

Introduction: Ocular trauma is a significant cause of unilateral vision loss, especially in developing countries. Proper assessment of ocular damage and prompt treatment initiation after the injury have a crucial impact on the final outcome. B-scan Ultrasonography (USG) plays an important role in detecting findings that may not be evident during clinical examination. Aim: To assess the role of B-scan in blunt ocular trauma and to determine if B-scan provides any additional advantages over clinical examination. Materials and Methods: A cross-sectional study was conducted from May 1, 2021 to April 30, 2022, at Hind Institute of Medical Sciences, Sitapur, Uttar Pradesh, India. Fifty consecutive patients with blunt ocular trauma, presenting with hazy or opaque ocular media or unexplained visual loss during clinical examination, were evaluated in the casualty and ophthalmology Out Patient Department (OPD). The frequency of lesions such as traumatic cataract, vitreous degeneration, and retinal detachment was assessed clinically and using B-scan USG. Anterior and posterior segment manifestations of blunt trauma, including traumatic cataract, vitreous haemorrhage, and retinal detachment, were evaluated clinically and with B-scan imaging. Statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) version 22.0, including frequency counts, percentage calculations, and Kappa’s statistical analysis to correlate B-scan USG and clinical findings. Results: Majority of patients (28%) were in the age group of 21-30 years. Workplace-related injuries, particularly agricultural injuries, were the most common cause of blunt ocular trauma (30%). Traumatic cataract (44%), vitreous degeneration (8%), vitreous haemorrhage (6%), and retinal detachment (4%) were the common clinical posterior segment findings. On B-scan USG, the most frequent findings were retinal detachment (30%) and vitreous haemorrhage (28%). Choroidal detachment was noted in 2% of cases. B-scan USG was more helpful in accurately diagnosing vitreous lesions and retinal lesions (52%, 30%) compared to clinical examination (16%, 6%). Conclusion: B-scan USG emerged as a superior diagnostic tool for identifying posterior segment lesions, including vitreous, retinal, and choroidal lesions. Lesions such as retinal detachment and vitreous haemorrhage were more easily identified using USG, especially in the presence of hazy or opaque media. Therefore, B-scan USG should be considered an integral part of all ophthalmic set-ups dealing with trauma to avoid missing significant posterior segment pathologies.