Eye Spy: POCUS Uncovers a Hidden Metallic Foreign Body
Faint wound near the 2 o’clock position of an otherwise normal-appearing right eye, which could be mistaken for a superficial injury. Given the concerning mechanism, POCUS was performed.
Hyperechoic linear structure penetrating the globe, concerning for a retained metallic intraocular foreign body. This bedside finding prompted immediate ophthalmology consultation, initiation of antibiotics, and urgent transfer for surgical management.
Hyperechoic linear structure penetrating the globe, concerning for a retained metallic intraocular foreign body. This bedside finding prompted immediate ophthalmology consultation, initiation of antibiotics, and urgent transfer for surgical management.
Non-contrast orbital CT congruent with the POCUS diagnosis. This case highlights the value of POCUS in identifying occult globe injury, expediting disposition, and reducing delays in time-sensitive ophthalmologic emergencies.
References
Alsulami RR, Almutairi JA, Almatrafi MI, Othman BS. Expanding Ocular Care in the Emergency Department: A Comprehensive Review of the Utility of Point-of-Care Ultrasound for Ocular Emergencies. Cureus. 2024;16(11):e74548. doi:10.7759/cureus.74548
Minhaz AT, Orge FH, Wilson DL, Bayat M. Assessment of intraocular foreign body using high resolution 3D ultrasound imaging. Sci Rep. 2024;14(1):12011. doi:10.1038/s41598-024-62362-y
Patel SN, Langer PD, Zarbin MA, Bhagat N. Diagnostic value of clinical examination and radiographic imaging in identification of intraocular foreign bodies in open globe injury. Eur J Ophthalmol. 2012;22(2):259-268. doi:10.5301/EJO.2011.8347
Propst SL, Kirschner JM, Strachan CC, et al. Ocular Point-of-Care Ultrasonography to Diagnose Posterior Chamber Abnormalities: A Systematic Review and Meta-analysis. JAMA Netw Open. 2020;3(2):e1921460. doi:10.1001/jamanetworkopen.2019.21460
Sargsyan AE, Dulchavsky AG, Adams J, Melton S, Hamilton DR, Dulchavsky SA. Ultrasound detection of simulated intra-ocular foreign bodies by minimally trained personnel. Aviat Space Environ Med. 2008;79(1):58-61. doi:10.3357/asem.2191.2008
Skidmore C, Saurey T, Ferre RM, Rodriguez-Brizuela R, Spaulding J, Lundgreen Mason N. A Narrative Review of Common Uses of Ophthalmic Ultrasound in Emergency Medicine. J Emerg Med. 2021;60(1):80-89. doi:10.1016/j.jemermed.2020.08.003
Wang K, Liu J, Chen M. Role of B-scan ultrasonography in the localization of intraocular foreign bodies in the anterior segment: a report of three cases. BMC Ophthalmol. 2015;15:102. doi:10.1186/s12886-015-0076-1