Ultrasound biomicroscopy diagnosis of traumatic choroid effusion without cyclodialysis

Abstract

Chamber angle changes due to trauma represent a diagnostic challenge in modern ophthalmology and two examination techniques are compared: gonioscopy which has been used in ophthalmology for almost a century and is still undergoing continuous improvements and ultrasound biomicroscopy (UBM) which was introduced into clinical ophthalmology in 1991. We report the case of a 14-year-old boy with ocular trauma caused by a soft gun projectile. Gonioscopy showed a large goniosynechia in the presence of ocular hypotension, therefore, cyclodialysis was suspected. However, a control investigation using UBM showed an intact and circularly attached but anteverted ciliary body behind the synechia, a circular choroidal effusion and an anterior displacement of the iris-lens diaphragm. In ocular trauma, UBM may under certain conditions clearly be of a higher diagnostic value than gonioscopy. Therefore, UBM should not only be considered as an additional examination technique in the evaluation of traumatic ocular pathologies but rather as the technique of choice.