Dx: Globe Rupture on Ultrasound
The right eye appears normal on ultrasound. The anterior chamber (AC), lens, and vitreous body appear atraumatic on the scan (above).
In contrast, the left eye appears grossly abnormal and you suspect your intern has picked up one of the most interesting cases of the night. The lens appears grossly intact, but the anterior chamber is flattened, and the vitreous body is filled with hyperechoic contents, likely clotted blood, mixed in with the vitreous humor. (below).
You suspect that the patient has sustained a globe rupture from blunt orbital trauma and your team moves quickly to notify ophthalmology and plastic surgery of their new patient. As your battered and bruised bar-brawling patient gets wheeled off to the CT scanner to evaluate for other associated injuries, your intern gives you a thumbs up sign and remarks, “Now THAT was totally cool! Seeing really IS believing.”
Teresa S. Wu is the Assistant Residency Director, and Director of Ultrasound and Simulation Based Training for the Maricopa Emergency Medicine Program in Phoenix, Arizona.
Brady Pregerson manages a free online EM Ultrasound Image Library and is the editor of the Emergency Medicine Pocketbook series. For more information visit www.EMResource.org
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