Name of the Procedure:

Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative A-scan)
Common name(s): B-scan Ultrasound, Diagnostic Ophthalmic Ultrasound

Summary

A B-scan ultrasound is a diagnostic imaging procedure that uses sound waves to create a two-dimensional cross-sectional view of the eye and the orbit (the eye socket). It helps doctors visualize the eye's internal structures when direct observation is not possible.

Purpose

The B-scan ultrasound addresses a variety of eye conditions where direct viewing is obstructed, such as behind opaque media like the cornea, lens, or vitreous humor (the gel filling the eye). The primary goal is to diagnose and evaluate abnormalities in the eye and orbital tissues, including tumors, retinal detachments, hemorrhages, and foreign bodies.

Indications

• Sudden vision loss with an unknown cause
• Suspected retinal detachment
• Presence of intraocular tumors or foreign bodies
• Eye trauma
• Dense cataracts obstructing direct examination
• Vitreous hemorrhage

Preparation

• No special preparation is typically needed.
• Patients may be advised to remove contact lenses.
• A comprehensive eye examination and medical history review may be conducted prior to the ultrasound.

Procedure Description

1. The patient is seated comfortably, and a topical anesthetic may be applied to the eye to minimize discomfort.
2. A conductive gel is spread over the closed eyelid.
3. A transducer (ultrasound probe) is gently placed against the eyelid or the surface of the eye.
4. The technician moves the transducer around to capture detailed images from different angles.
5. The sound waves generate real-time images displayed on a monitor for evaluation by the physician.

Duration

The procedure typically takes about 15-30 minutes.

Setting

The procedure is performed in an ophthalmologist's office or an outpatient clinic specializing in eye care.

Personnel

• Ophthalmologist
• Ultrasound technician

Risks and Complications

• Minimal risks associated with the procedure
• Rarely, mild discomfort or irritation from the conductive gel or transducer
• Very low risk of allergic reaction to the anesthetic if used

Benefits

• Provides critical diagnostic information when direct visualization is not possible
• Fast and non-invasive with immediate results for quick diagnosis and treatment planning

Recovery

• No significant recovery time needed
• Patients can typically resume normal activities immediately
• Follow-up appointments based on the findings of the ultrasound

Alternatives

• Optical coherence tomography (OCT) for certain conditions
• MRI or CT scans for detailed imaging of orbital structures
• Each alternative has varying detail, cost, and availability

Patient Experience

• Patients may feel slight pressure from the transducer on the eyelid
• Generally, a comfortable and pain-free procedure
• The conductive gel used might feel a bit cold and wet