January 03, 2024

How to Perform an Ocular Ultrasound

Written by: Casey Green

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Preparing for the Scan

Before initiating the eye ultrasound, it's crucial to exercise caution to avoid prolonged scanning as excessive exposure can elevate the eye's temperature, potentially causing damage. To mitigate this risk, accessing the ophthalmic setting on the machine is essential. Reducing the M. I. (Mechanical Index) to 0.2 minimizes the energy directed towards the eye, ensuring safer scanning parameters, especially vital in cases involving eye injuries.

Ensuring Patient Comfort and Safety

When dealing with a patient with an eye injury, minimizing pressure transmission from the probe to the eye is paramount. Generously using gel, preferably sterile, aids in easing the scanning process. Application methods vary, from placing gel on a closed eyelid to directly applying it to the transducer or even utilizing a plastic wrap, tegaderm, or other similar material. with caution due to potential eyelash entanglement upon removal.

Proper Technique and Positioning

Optimal handling of the probe is crucial for accurate imaging and patient comfort. Employing the first three fingers while resting the hand on the patient's face—nose or orbital rim—distributes pressure, ensuring gentle probe contact with the eyelid. Adjusting depth settings to encompass the entire globe facilitates visualization, notably showcasing the optic nerve and structures within the anterior chamber and lens.

Assessing Eye Movement and Function

By manipulating the probe's position, observing eye movement becomes feasible, allowing for comprehensive evaluation. Positioning the probe superiorly and angling it inferiorly enables visualization of the pupil, offering insights into the afferent pupillary light reflex. This reflex response aids in assessing eye trauma cases, especially when the eye is swollen and difficult to evaluate conventionally.

Clinical Applications and Continued Learning

Utilizing the pupillary light reflex as a diagnostic tool in trauma cases is particularly valuable. By testing the unaffected eye's response to light, clinicians can assess pupil reactivity, offering critical information when direct evaluation of the affected eye is challenging.

Learning Resources

For more information on Ocular Ultrasound, Gulfcoast Ultrasound Institute offers resources and courses, Ocular ultrasound is included covered song with numerous other topics in Emergency and Critical Care Ultrasound Courses 

Contact Gulfcoast Ultrasound Institute at 

111 2nd Ave NE, #800 

St. Petersburg, FL 33701

Phone: 727-363-4500 

YouTube Link:

   Point of Care Ultrasound Courses and Products


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Casey Green Business Development Supervisor


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