Radiography of eye

1. RADIOGRAPHY OF
EYE
BY RAVI JAICHAND
RADIOGRAPHER
INDIA

2. EYE
ORGAN OF VISION
LATIN -OCULUS
GREEK-OPHTHALMUS

3. ANATOMY

5. •INDICATION
LOCALIZATION OF FOREIGN BODY
•ALTERNATE TECHNIQUES USED
ULTRASOUND AND COMPUTED TOMOGRAPHY
MRI SHOULD NEVER BE USED

6. OBSOLETE METHODS
VOGT METHOD
SWEET METHOD
PFEIFFER COMBERG METHOD
PARALLAX MOTION METHOD

7. •IMAGE QUALITY IS OF SUPREME IMPORTANCE FOR
DETECTION AND LOCALIZATION OF MINUTE FOREIGN PARTICLES.
•TO IMPROVE IMAGE QUALITY
REDUCE GEOMETRIC UN SHARPNESS
USE CLOSE OID
USE SMALL FOCAL SPOT
USE STANDARD FFD

8. IMAGE QUALITY
• MINIMIZE SECONDARY RADIATION (USE CLOSE
COLLIMATION)
• USE IMMOBILIZATION DEVICES TO IMMOBILIZE
HEAD.HAVE THE PATIENT GAZE STEADILY AT A FIXED
OBJECT SO AS TO IMMOBILIZE EYEBALLS.
IMAGE RECEPTORS MUST BE VERY CLEAR AS ANY
ARTIFACT CAN SIMULATE FOREIGN BODY
(CAN HAVE RESERVE IMAGE RECEPTOR FOR EYE
STUDIES ONLY)

9. BASIC PROJECTIONS
• LATERAL PROJECTION
• PA AXIAL PROJECTION
• PARIETOCANTHAL PROJECTION (MODIFIED WATER’S VIEW)
IF A FOREIGN BODY IS SUSPECTED, THEN A SECOND PROJECTION MAY BE
UNDERTAKEN, WITH THE EYES IN A DIFFERENT POSITION TO DIFFERENTIATE
THIS FROM AN IMAGE ARTIFACT. THE INITIAL EXPOSURE COULD BE TAKEN WITH
THE EYES POINTING UP AND THE SECOND WITH THE EYES POINTING DOWN.

10. LATERAL PROJECTION
RIGHT OR LEFT
USE NON GRID TECHNIQUE TO REDUCE
MAGNIFICATION AND ARTIFACTS FROM
RADIOGRAPHIC TABLE AND GRID

11. LATERAL PROJECTION
SEMIPRONE OR ERECT
Mid sagittal plane of the
patient parallel to the
image receptor
Affected eye adjacent to
center of image receptor
Inter pupillary line
perpendicular to the image
receptor
Exposure made in
suspended respiration

12. LATERAL PROJECTION CENTRAL RAY
PERPENDICULA
R THROUGH
THE OUTER
CATHUS
INSTRUCT THE
PATIENT TO
LOOK
STRAIGHT
AHEAD DURING
EXPOSURE

13. LATERAL PROJECTION EVALUATION
CRITERIA
CLOSE BEAM RESTRICTION
SUPERIMPOSITION OF
ORBITAL ROOF
OPTIMUM DENSITY AND
CONTRAST FOT
VISUALIZATION OF FOREIGN
BODY

14. PA AXIAL PROJECTION
USE NON GRID TECHNIQUE TO REDUCE
MAGNIFICATION AND ARTIFACTS FROM
RADIOGRAPHIC TABLE AND GRID

15. PA AXIAL PROJECTION
PATIENT POSITIONING
EXPOSURE MADE IN SUSPENDED RESPIRATION
PATIENT’S HEAD
REST OVER THE
IMAGE RECEPTOR
RADIOGRAPHIC
BASE LINE
PERPENDICULAR TO
THE IMAGE
RECEPTOR

16. PA AXIAL PROJECTION CENTRAL RAY
INSTRUCT THE
PATIENT TO
CLOSE EYES
&CONCENTRATE
HOLDING THEM
STRAIGHT
THROUGH THE
CENTRE OF THE
ORBITS WITH 30
DEGREE CAUDAL
ANGULATION,
PROJECT THE
PETROUS PORTION
OF THE TEMPORAL
BONE BELOW
INFERIOR MARGIN
OF ORBITS

17. EVALUATION CRITERIA
NO ROTATION OF THE CRANIUM
PETROUS PYRAMIDS LYING
BELOW ORBITAL SHADOW
BEAM RESTRICTION CENTRED TO
ORBITAL MARGINS

18. PARIETOCANTHAL PROJECTION
MODIFIED WATER’S VIEW
THE PETROUS MARGINS ARE DISPLACED BY PART
ADJUSTMENT RATHER THAN BY CENTRAL RAY
ANGULATION

19. PARIETOCANTHAL PROJECTION
PATIENT POSITIONING
EXPOSURE MADE IN SUSPENDED
RESPIRATION REST
PATIENT’S
CHIN ON
IMAGE
RECEPTOR
HOLDER
MID SAGGITAL
PLANE
PERPENDICULA
R TO THE PLANE
OF IMAGE
RECEPTOR
ADJUST THE FLEXION
OF THE HEAD SO THAT
THE RADIOGRAPHIC
BASE LINE FORMS AN
ANGLE OF 50 DEGREES
WITH THE IMAGE
RECEPTOR

20. PARIETOCANTHAL PROJECTION CENTRAL
RAY
PERPENDICULAR THROUGH THE MID
ORBITS
INSTRUCT THE PATIENT TO CLOSE EYES
AND CONCENTRATE ON HOLDING THEM
STRAIGHT

21. EVALUATION CRITERIA
NO ROTATION OF THE CRANIUM
PETROUS PYRAMIDS LYING
BELOW ORBITAL SHADOW
BEAM RESTRICTION CENTRED TO
ORBITAL MARGINS

22. REFERENCES
• MERRILL'S ATLAS OF RADIOGRAPHIC POSITIONS AND RADIOLOGIC
PROCEDURES. ED 10,VOLUME 2, AUTHORS PHILIP W. BALLINGER ,
EUGENE D. FRANK
• CLARK’S POSITIONING IN RADIOGRAPHY,12TH EDITION, AUTHORS A. STEWART
WHITLEY CHARLES SLOANE GR AHAM HOADLEY ADRIAN D. MOORE CHRISSIE
W.ALSOP