Unique Method of Ocular Ultrasound Using Transparent Dressings

Abstract

Utilizing bedside ocular ultrasound to aid in diagnosing pathology such as retinal detachment, lens disruption, ocular foreign bodies, or increased intracranial pressure is becoming more pervasive in the Emergency Department. To eliminate an air interface, one must apply ultrasound gel between the patient's skin and the probe. In ocular ultrasound, this practice results in discomfort for the patient as gel seeps into their eyes. To limit patient discomfort, many physicians do not apply a sufficient amount of gel for the examination. This can result in decreased image quality and may cause the ultrasonographer to apply greater pressure to the eye to obtain a satisfactory image. This can be harmful to patients with a ruptured globe and may also be painful to the patient. Traditionally, the first step in ocular ultrasound is to place a generous amount of water-soluble ultrasound gel on the eyelid to eliminate the air interface. The authors promote a different and simple technique. A transparent dressing is placed over a closed eye. A generous amount of ultrasound gel is applied to the dressing. A linear ultrasound probe is then placed on the gel and a standard ultrasound scan is obtained. Transparent dressings, which are used as sterile coverings for i.v. sites, have been found to allow satisfactory ultrasound transmission. These products remove the air interface between the eyelid and the dressing. This allows ultrasound gel to be placed on the transparent dressing and not directly on the eyelid, potentially eliminating discomfort for the patient, and creating an easier cleanup. Because a generous amount of ultrasound gel is applied, the ultrasonographer is able to apply minimal pressure on the eye to complete the study, which may decrease harm to the patient's eye. When finished, the transparent dressing is removed. There is no cleanup or patient irritation. This article demonstrates a unique method of ocular ultrasound. The technique can be easily incorporated into emergency bedside ocular ultrasound.