Sonography of the eye is useful in children especially when ophthalmoscopic examination is limited or inconclusive. Most of our requests are from paediatric ophthalmologists that want to further evaluate the eye so as to achieve a more accurate diagnosis. Ultrasound plays an important role allowing real time, quick and dynamic evaluation of the eye.
The anatomy of the eye is easy to visualise on ultrasound as it is a superficial fluid filled structure. Not only can the anterior chamber be visualised but the posterior chamber including the optic nerve. Performing an eye ultrasound on a baby or young child can be challenging at times therefore some helpful tips will be included in the scanning technique.
Masses that lie in close proximity to the eye, for example infantile haemangiomas can also be scanned in the same manner. The technique discussed not only applies to paediatrics but also to adults. An awareness of the correct machine settings for mechanical index is important when performing the scan. Indications for performing an eye ultrasound can be for trauma or non-trauma. Point of Care Ultrasound is being used for the evaluation of the traumatic eye in many emergency departments. This provides the benefit of making a timely diagnosis. Common pathologies seen in trauma include haemorrhage and retinal detachment. Non trauma pathology examples are tumours and Persistent Hyperplastic Primary Vitreous. A discussion of the sonographic findings in the most common paediatric eye pathologies we encounter and some differential diagnoses will be made. Although ultrasound is used to image the eye there are limitations when using it to assess a mass and this is where MRI can be useful in making a more accurate diagnosis