Evaluation Of Posterior Segment In Opaque Media By Bscan By Cross-Sectional Study

Abstract

INTRODUCTION: Eye is affected by a spectrum of pathological conditions occurring in all age groups from new born to old age. Clinical examination and ophthalmoscopy forms the basis of diagnosis in most patients with eye disease but in many cases, especially when the clinical examination of the ocular fundus is difficult, other techniques will be required, ultrasound being one of them. Ultrasound is a safe technique, cheaper and more affordable compared to other techniques. Dynamic examination is important and with B-scan ultrasound it’s possible to study characteristics of the motion and topography of pathological intraocular conditions. Echography has become the most important method for evaluating an eye with opaque ocular media. It provides an instantaneous ‘glimpse’ into the eye and, in many instances can yield information not obtainable by any other method. OBJECTIVES: To evaluate the status of the posterior segment of the eye with B-scan ultrasound in the event of non-visualisation of fundus. MATERIALS AND METHODS: The descriptive study was conducted on patients attending/referred to the Outpatient Department of Ophthalmology in KLES Hospital, Belagavi from January 2015 to December 2015 for evaluation of the posterior segment of the eye.250 patients were evaluated using a standard USG machine (SONOMED) equipped with a real-time high-frequency probe with the contact method. The probe was placed over the closed eyelid after application of a coupling gel. RESULTS: Highest number of cases was seen in the age group of 51 to 60 years which accounted for 18% of cases. Commonest clinical presentations were diminution of vision . The commonest sites of media opacity were found to be in the lens (61%) and the vitreous (12%).Common pathologies detected were retinal detachment, vitreous hemorrhage and posterior vitreous detachment. Out of the 250 patients studied, 11 patients (4%) had retinal detachment, 24 patients (10%) had posterior vitreous detachment, 3 patients (1%) had vitreous hemorrhage, 13 patients (5%) had diffuse vitreous opacities, 8 patients (3%) had vitreous degeneration, 3 patients (1%) had posterior staphyloma, 2 patients (1%) had retinal detachment with posterior staphyloma, 1 patients had vitreous hemorrhage with retinal detachment, 1 patient (0.8%) had subhyaloidhemorrhage, 1 patient (0.4%) had choroidal detachment, 1 patient (1%) had optic disc coloboma, 2 patients had previously implanted scleral buckle. CONCLUSION: B-scan ultrasound is a simple, safe, non-invasive, cost-effective, easily available, reproducible and quick investigative technique which proves accurate and beneficial in opaque ocular media to detect posterior segment pathologies. It is advisable to all patients who present with opaque ocular media as a screening device for ocular pathology which will facilitate early diagnosis and management of diseases like retinal detachment and intraocular tumours. With understanding of the indications for ultrasonography and proper examination techniques, one can gather a vast amount of information not possible with clinical examination alone.