Letter to the Editor
Usefulness of point-of-care ultrasound for the evaluation of non-traumatic eye emergencies
Utilidad de la ecografía clínica en la valoración de la enfermedad ocular urgente no traumática
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We also liked the authors' approach to the subject, which is based on the ocular structures involved rather than on specific diseases. However, we have missed 3 potential eye emergencies, sometimes non-traumatic, that were not described in the review and in which ultrasound can be a key diagnostic tool, such as posterior scleritis, carotid-cavernous fistula and orbital inflammatory disease.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Posterior scleritis can be diffuse or nodular. The latter is characterized on ultrasound by a solid mass of medium to high hyperchogenicity, with an adjacent hypoechoic area produced by the presence of scleral oedema, sometimes accompanied by fluid in Tenon's capsule, which gives a characteristic image called the "T-sign".<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2,3</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">While most carotid-cavernous fistulas have a traumatic origin, up to 24% are spontaneous. Low flow between the cavernous sinus and one or more meningeal branches of the internal or external carotid artery, or both, is typical. The ultrasound may show thickening of the extraocular muscles compared to the contralateral muscles, retrograde flow in the superior orbital vein, decreased flow and increased resistive index of the ipsilateral central retinal artery.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Finally, in addition to cellulitis, which is well described by the authors in the structure of the orbit, ultrasound can be especially useful in differentiating the structures on which idiopathic inflammatory disease depends, such as the lacrimal gland, the musculature or the cone fat, among others.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">We therefore agree with the authors that ultrasound is a particularly useful tool that allows us to identify different eye emergencies quickly and accurately.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Callejas Rubio JL, García Sarrano JL, Ortego Centeno N. Utilidad de la ecografía clínica en la valoración de la enfermedad ocular urgente no traumática. Med Clin (Barc). 2022;158:344–345.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Usefulness of point-of-care ultrasound for the evaluation of non-traumatic eye emergencies" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "L. Castilla-Guerra" 1 => "A. Gómez-Escobar" 2 => "E. 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Gündüz" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:2 [ "tituloSerie" => "Middle East Afr J Ophthalmol" "fecha" => "2018" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000015800000007/v1_202205040609/S2387020622001176/v1_202205040609/en/main.assets" "Apartado" => array:4 [ "identificador" => "43309" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000015800000007/v1_202205040609/S2387020622001176/v1_202205040609/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020622001176?idApp=UINPBA00004N" ]
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