Ultrasound is one of the oldest imaging modalities. Sound waves are emitted into the body, and the returning echoes can be interpreted. It has become widely used because it can easily be done at bedside with a relatively small apparatus and does not expose the patient to any ionizing radiation. While this technique has seen widespread acceptance in other fields such as cardiology or obstetrics and gynecology, the general use in ophthalmology has been somewhat limited. However, recent advancements in ultrasonic arrays can be a powerful tool in the evaluation of ophthalmic pathology. Such systems can quickly generate very high detail images and 3D reconstructions without the need for extensive manual scanning. The application of this technology includes evaluation of traumatic eye injuries; assessing presence and location of an intraocular foreign body; evaluation of intraocular tumors, including small tumors that have not yet caused visual distortion; evaluation of retinal detachment; and evaluation of vascular disease. The goal of this article is to briefly review the history and development of ultrasound and to provide an overview of the most current systems and applications of ultrasound use in ophthalmologic clinical evaluation.
Part of the book: Novel Diagnostic Methods in Ophthalmology
Globally, there are almost 300 million people blind and visually impaired and over 90% live developing countries. The gross disparity in access to ophthalmologists limits the ability to accurately diagnose potentially blinding conditions like cataract, glaucoma, trachoma, uncorrected refractive error and limits timely initiation of medical and surgical treatment. Since 85% of blindness is preventable, bridging this chasm for care is even more critical in preventing needless blindness. Many low-income countries must rely on community health workers, physician assistants, and cataract surgeons for primary eye care. Ophthalmology in low-income countries (LIC) is further challenging due to complexities brought from tropical climates, frail electric grids, poor road and water infrastructure, limited diagnostic capability and limited treatment options. Vision 2020 set the goal of eliminating preventable blindness by 2020 despite formidable obstacles. Innovative technologies are emerging to test visual acuity, correct refractive error quickly and inexpensively, capture retinal images with portable tools, train cataract surgeons using simulators, capitalize on mHealth, access ophthalmic information remotely. These advancements are allowing nonspecialized ophthalmic practitioners to provide low-cost, high impact eye care in resource-limited regions around the world.
Part of the book: Novel Diagnostic Methods in Ophthalmology
This chapter comprehensively covers all aspects of endogenous endophthalmitis from systemic infectious agents, with an emphasis on reported and newer etiologies to broaden the diagnostic and investigative acumen of treating ophthalmic providers. The discussion includes the etiology of metastatic endophthalmitis and diagnostic investigations, including polymerase chain reaction (PCR), for identification of bacterial and viral infections involving the eye in both immunosuppressed in non-immunosuppressed patients. Additionally, we present clinical and diagnostic findings of fungal infections, protozoal infections, and helminthic infections. Pediatric cases are also reported and etiologies described. We discuss both etiology and diagnostic challenges. Current therapeutic modalities and outcomes are reviewed. While no two cases of metastatic endophthalmitis are the same, some similarities may exist that allow us to generalize how to approach and treat this potentially sight- and life-threatening spectrum of diseases and find the underlying systemic cause.
Part of the book: Infectious Eye Diseases