B-scan ultrasonography provides two-dimensional images of the eye that can be used to evaluate various ocular conditions. It was first used in ophthalmology in the 1960s. B-scan uses high frequency sound waves to produce images, and can visualize the shape, location, and thickness of intraocular tissues. It is useful for evaluating conditions like dense cataracts, retinal detachments, vitreous hemorrhages, and intraocular tumors. B-scan imaging involves moving the probe in different positions and angles to obtain axial, transverse, and longitudinal sections of the eye.
B-scan ultrasonography provides two-dimensional images of ocular structures through the use of high frequency sound waves. It can be used to evaluate a variety of conditions, including retinal detachment, vitreous hemorrhage, intraocular tumors, and trauma. Retinal detachment appears on B-scan as an echogenic membrane attached to the optic nerve head, while vitreous hemorrhage shows as fine echo opacities within the vitreous cavity. B-scan is useful for assessing patients with dense cataracts or other opaque media by allowing visualization of the posterior segment.
ULTRASONOGRAPHY (USG) AND ULTRASOUND BIOMICROSCOPY(UBM)Dr. Gaurav Shukla
Ultrasonography and ultrasound biomicroscopy are important tools for diagnosing ocular and orbital abnormalities. Ultrasonography uses high frequency sound waves transmitted into the eye via a probe to image intraocular structures. A-scans display returning echoes in one dimension while B-scans create a two-dimensional image by accumulating A-scan echoes. B-scans are useful for evaluating lesions' topography, reflectivity, internal structure, and mobility. Common applications include detecting retinal detachments, vitreous opacities, intraocular tumors, and foreign bodies. Ultrasonography is valuable for screening and characterizing many ocular pathologies.
Ultrasonography of the eye uses high frequency sound waves to image internal ocular structures. It can be used to evaluate lesions when the media is opaque, differentiate solid from cystic masses, and identify foreign bodies. There are different probe positions and orientations used to image different areas. Indications include evaluating masses, detachments, tumors, and foreign bodies or assessing intraocular details obscured by media opacities. Interpretation involves analyzing reflectivity, density, shape, borders and internal characteristics of lesions and other structures.
B-scan ultrasonography uses ultrasound waves to non-invasively diagnose posterior segment eye lesions. It provides topographic information on the shape, location, extension, mobility and thickness of tissues. B-scan imaging was developed in the 1950s and 1960s and allows visualization of structures behind opaque tissues. It uses a transducer to transmit ultrasound pulses that are partially reflected by tissues, with the reflections detected to produce images. Different orientations of the transducer probe, such as longitudinal, transverse and axial, allow imaging of different areas of the eye and orbit. B-scan is useful for evaluating a variety of conditions when the ocular media is opaque, including tumors, retinal detachments, intraocular foreign bodies and more.
The document discusses B-scan ultrasound, providing a history of its development and describing the technical aspects and clinical applications. It notes that B-scan utilizes high frequency sound waves to produce two-dimensional images, and was first introduced in 1958. The document outlines the physics behind B-scan, describing how sound waves are reflected and the factors that determine resolution. Clinical uses mentioned include evaluating vitreous opacities, retinal detachments, and tumors.
This document discusses ultrasound techniques used in ophthalmology. It begins by providing background on ultrasound waves and the early development of A-scan and B-scan techniques in the 1950s-1970s. It then describes the basic components and mechanisms of A-scan and B-scan ultrasound probes. The remainder of the document details various ultrasound techniques and their applications, including evaluating the vitreous, retina, choroid, tumors, trauma, and performing biometry. It provides guidance on interpreting ultrasound findings and differentiating various pathologies. In summary, this document serves as a comprehensive guide to ophthalmic ultrasound acquisition and interpretation.
Analog radiography, also known as conventional radiography, involves exposing x-ray film to x-rays to produce radiographic images. It has been used in dentistry since the late 1890s and remains important for diagnosis, treatment planning and assessing treatment outcomes. While it has limitations like image distortion and superimposition, analog radiography is easy to use, cost effective, and prevents fraudulent images. Essential steps include using the correct film speed and angle, and taking diagnostic, working and recall radiographs for evaluation.
B-scan ultrasonography provides two-dimensional images of ocular structures through the use of high frequency sound waves. It can be used to evaluate a variety of conditions, including retinal detachment, vitreous hemorrhage, intraocular tumors, and trauma. Retinal detachment appears on B-scan as an echogenic membrane attached to the optic nerve head, while vitreous hemorrhage shows as fine echo opacities within the vitreous cavity. B-scan is useful for assessing patients with dense cataracts or other opaque media by allowing visualization of the posterior segment.
ULTRASONOGRAPHY (USG) AND ULTRASOUND BIOMICROSCOPY(UBM)Dr. Gaurav Shukla
Ultrasonography and ultrasound biomicroscopy are important tools for diagnosing ocular and orbital abnormalities. Ultrasonography uses high frequency sound waves transmitted into the eye via a probe to image intraocular structures. A-scans display returning echoes in one dimension while B-scans create a two-dimensional image by accumulating A-scan echoes. B-scans are useful for evaluating lesions' topography, reflectivity, internal structure, and mobility. Common applications include detecting retinal detachments, vitreous opacities, intraocular tumors, and foreign bodies. Ultrasonography is valuable for screening and characterizing many ocular pathologies.
Ultrasonography of the eye uses high frequency sound waves to image internal ocular structures. It can be used to evaluate lesions when the media is opaque, differentiate solid from cystic masses, and identify foreign bodies. There are different probe positions and orientations used to image different areas. Indications include evaluating masses, detachments, tumors, and foreign bodies or assessing intraocular details obscured by media opacities. Interpretation involves analyzing reflectivity, density, shape, borders and internal characteristics of lesions and other structures.
B-scan ultrasonography uses ultrasound waves to non-invasively diagnose posterior segment eye lesions. It provides topographic information on the shape, location, extension, mobility and thickness of tissues. B-scan imaging was developed in the 1950s and 1960s and allows visualization of structures behind opaque tissues. It uses a transducer to transmit ultrasound pulses that are partially reflected by tissues, with the reflections detected to produce images. Different orientations of the transducer probe, such as longitudinal, transverse and axial, allow imaging of different areas of the eye and orbit. B-scan is useful for evaluating a variety of conditions when the ocular media is opaque, including tumors, retinal detachments, intraocular foreign bodies and more.
The document discusses B-scan ultrasound, providing a history of its development and describing the technical aspects and clinical applications. It notes that B-scan utilizes high frequency sound waves to produce two-dimensional images, and was first introduced in 1958. The document outlines the physics behind B-scan, describing how sound waves are reflected and the factors that determine resolution. Clinical uses mentioned include evaluating vitreous opacities, retinal detachments, and tumors.
This document discusses ultrasound techniques used in ophthalmology. It begins by providing background on ultrasound waves and the early development of A-scan and B-scan techniques in the 1950s-1970s. It then describes the basic components and mechanisms of A-scan and B-scan ultrasound probes. The remainder of the document details various ultrasound techniques and their applications, including evaluating the vitreous, retina, choroid, tumors, trauma, and performing biometry. It provides guidance on interpreting ultrasound findings and differentiating various pathologies. In summary, this document serves as a comprehensive guide to ophthalmic ultrasound acquisition and interpretation.
Analog radiography, also known as conventional radiography, involves exposing x-ray film to x-rays to produce radiographic images. It has been used in dentistry since the late 1890s and remains important for diagnosis, treatment planning and assessing treatment outcomes. While it has limitations like image distortion and superimposition, analog radiography is easy to use, cost effective, and prevents fraudulent images. Essential steps include using the correct film speed and angle, and taking diagnostic, working and recall radiographs for evaluation.
BScan and Ascan in ophthalmology and eye fieldAsif469093
This document provides an overview of B-scan ultrasound. It defines a B-scan as a brightness intensity-modulated display that is two-dimensional, with echoes displayed as dots where brightness indicates echo strength. It then discusses basic physics concepts for ultrasound such as velocity, reflectivity, absorption and artifacts. It also covers instrumentation, examination techniques including patient positioning and probe use, and types of scans based on probe position.
B-scan ultrasonography uses high frequency sound waves to produce 2D images of ocular structures. It can be used to evaluate the anterior segment, posterior segment, tumors, vitreous pathology, retinal detachments, and more. The probe transmits sound waves which bounce off tissues and return echoes that are amplified and displayed. This allows visualization of the retina, choroid, lens, vitreous humor and other structures. B-scan is useful for diagnosing and monitoring many ocular conditions.
The document provides information on B-scan ultrasonography. It begins by defining a B-scan as a two-dimensional brightness intensity-modulated display where echoes are shown as dots and stronger echoes appear brighter. It then discusses the basic physics of ultrasound, describing how sound waves are reflected and absorbed in different tissues. The document outlines appropriate techniques for B-scan examinations including patient positioning, probe usage, and methods for localizing structures like the macula. It provides an example of a normal ocular B-scan tomograph and labels key anatomical features.
Ultrasound is a useful tool for evaluating orbital diseases. It uses high frequency sound waves to create images of intraocular and orbital structures. A systematic ultrasound examination involves evaluating the orbital soft tissues, extraocular muscles, and retrobulbar optic nerve. Abnormalities are identified based on changes in location, size, shape, internal reflectivity, and mobility compared to the normal structures. This allows differentiation of various pathologies, such as cysts, masses, muscle thickening, and optic nerve swelling. A comprehensive ultrasound examination provides valuable information for diagnosing and monitoring orbital diseases.
Ocular Ultrasound is an ultrasound for eyes that uses high frequency sound waves to get detailed pictures of your eye and it's orbit. This procedure is usually done by Ophthalmologists.
This document provides an overview of B-scan ultrasonography. It begins with an introduction to B-scans and their use in providing qualitative and quantitative assessment of the eye and orbit. It then discusses the physics and principles behind ultrasound, including reflection, absorption, resolution and other key concepts. The document outlines the components and use of B-scan ultrasound machines, including different probe orientations and scanning techniques. It concludes with clinical applications and indications for B-scan ultrasonography in evaluating ocular pathology.
This document provides information on imaging techniques used to examine the eye and orbit, including normal anatomy. It discusses plain radiography, dacryocystography, angiography, ultrasound, CT, and MRI. For each technique, it describes the procedure, indications, advantages, limitations, and provides examples of normal and abnormal findings. Ultrasound is discussed in more depth, covering techniques, examination of structures like the lens and vitreous, color Doppler, and indications for ocular ultrasound including both congenital and acquired pathologies.
Ultrasonography, also known as B-scan, was first used in ophthalmology in the 1940s. It uses high frequency sound waves to generate images of the inside of the eye. B-scans can be used to evaluate conditions like tumors, retinal detachments, and vitreous opacities. The document discusses the history, physics, principles and various applications of B-scan ultrasonography for examining the eye. Key aspects covered include probe orientation, scan types, interpretation of echogenicity and advantages in providing a non-invasive evaluation of intraocular structures.
This document discusses ultrasonography in ophthalmology. It defines ultrasonography as using acoustic waves with frequencies greater than 20kHz. The main advantages of ultrasonography in ophthalmology are that it is easy to use, involves no ionizing radiation, allows for excellent tissue differentiation, and is cost-effective. The primary uses in ophthalmology are for evaluating the posterior segment in hazy media, detecting intraocular and orbital lesions or foreign bodies, and performing ocular biometry for intraocular lens power calculation. The document describes the basic components of ultrasonography machines and provides examples of A-scan and B-scan display modes and various scanning positions and techniques.
Videokeratography uses a video camera to capture images of the corneal reflection of illuminated rings placed in front of the eye. This allows measurement of the entire corneal contour rather than just a few points like with a keratometer. The images are analyzed by a computer to generate corneal topography maps showing the dioptric power or elevation across the surface. These maps can detect conditions like keratoconus and pellucid marginal degeneration by their characteristic patterns of steepening and assist in monitoring refractive surgery outcomes and contact lens fitting. Keratoconus commonly shows an initial inferior steepening that progresses rotationally.
A-scan biometry is an ultrasound test used to measure the length of the eye, which is important for determining treatments for sight disorders. It works by emitting a sound beam into the eye and measuring the echoes that bounce back from different structures. The measurements of axial length, corneal curvature, and estimated lens position are used to calculate the ideal intraocular lens power needed after cataract surgery. Accuracy is important as even small errors in measurement can significantly impact the calculated lens power. Different formulas exist to relate the biometry measurements to the appropriate lens power, with newer regression formulas found to be most accurate.
This document provides an overview of ultrasound principles and techniques for ophthalmic examination. It discusses the history of ultrasound in ophthalmology and describes A-scan, B-scan, and UBM modalities. Examination techniques for evaluating the globe, orbit, and various ocular structures are outlined. Indications for diagnostic ultrasound include evaluating the lens, vitreous, retina, tumors, and more. Clinical examples of pathologies visualized by ultrasound are also presented.
This document provides an overview of B-Scan ultrasonography for ophthalmic imaging. It describes how B-Scan uses high frequency sound waves to generate images of the eye. Key points covered include the basic physics of ultrasound, different scanning techniques used to image the posterior eye segment, examples of images that can be obtained, and pathologies that can be visualized.
Ultrasonography uses high frequency sound waves to produce echoes from interfaces between structures in the eye. It has been used in ophthalmology since the 1950s, originally with A-scan and later developing B-scan technology. Ultrasound can image both clear and opaque ocular tissues. It is useful for evaluating conditions like tumors, retinal detachments, and vitreous hemorrhages. Examination involves different probe orientations and techniques depending on the area of interest. Findings are interpreted based on echo properties like size, reflectivity, and movement.
Thorough knowledge of the indications of various extra oral techniques allows accurate and timely diagnosis of various maxillofacial pathologies. Further, we can arrive at a diagnosis with minimum number of x-rays there by reducing patient exposure to radiation.
Point of Care Ultrasound - Hyperechoic Future in Medical School?cbyrne2014
This document discusses the potential role of point-of-care ultrasound (POCUS) in medical school. It begins with an overview of ultrasound fundamentals and image interpretation. It then examines how POCUS can efficiently address focused clinical questions at the bedside, such as detecting pneumothorax, pleural effusion, and pericardial effusion. Emerging evidence demonstrates POCUS has diagnostic accuracy comparable to other imaging modalities. The document argues POCUS could improve patient care, be a valuable clinical skill, and enhance career satisfaction if physicians receive proper training. It encourages readers to consider incorporating POCUS into their practice.
This document provides recommendations for imaging the orbit and eye. It discusses ultrasound, CT, and MR as modalities for evaluating intraocular lesions and complex orbital structures. Ultrasound is recommended as the first-line modality due its non-invasiveness. CT provides excellent evaluation of bone structures and detection of calcifications. MR offers superior soft tissue contrast for evaluating orbital and intracranial structures. Imaging protocols for CT and MR of the orbit and eye are outlined, including recommended sequences, planes of imaging, and use of contrast. Anatomical diagrams illustrate orbital bones and structures visible on different imaging views.
This document provides recommendations for imaging the orbit and eye. It discusses ultrasound, CT, and MR as modalities for evaluating intraocular lesions and complex orbital structures. Ultrasound is recommended as the first-line modality due its non-invasiveness and availability. CT provides excellent evaluation of bone structures and detection of calcifications. MR offers superior soft tissue contrast for evaluating orbital and intracranial structures. Imaging protocols for CT and MR of the orbit and eye are outlined, including recommended sequences, planes of imaging, and use of contrast. Anatomical diagrams illustrate orbital bones and structures visible on different imaging views.
Ultrasonography uses ultrasound to image tissues within the body. A-scan ultrasonography provides a one-dimensional view of the eye by measuring the echoes of ultrasound waves. It can be used to detect and measure tumors, assess eye structures for IOL calculation, and interpret pathology. The ultrasound is reflected at interfaces between tissues, appearing as spikes on the display. Immersion techniques provide more accurate measurements than contact techniques by avoiding compression artifacts. Limitations include artifacts, small lesions, missed foreign bodies, and misalignment issues.
Basic principles of ocular ultrasonographyRohit Rao
Ultrasound has been used in ophthalmology since the 1950s, with early pioneers developing A-scan and B-scan technologies. A-scan uses amplitude to represent echoes as vertical spikes, while B-scan displays echoes as brightness on a two-dimensional screen. Modes include A-scan for biometry and B-scan for diagnostic imaging. Later improvements included Doppler ultrasound and high-frequency ultrasound biomicroscopy. Ultrasound utilizes acoustic waves and principles of reflection and transmission to generate images of the eye and orbit.
10 Benefits an EPCR Software should Bring to EMS Organizations Traumasoft LLC
The benefits of an ePCR solution should extend to the whole EMS organization, not just certain groups of people or certain departments. It should provide more than just a form for entering and a database for storing information. It should also include a workflow of how information is communicated, used and stored across the entire organization.
BScan and Ascan in ophthalmology and eye fieldAsif469093
This document provides an overview of B-scan ultrasound. It defines a B-scan as a brightness intensity-modulated display that is two-dimensional, with echoes displayed as dots where brightness indicates echo strength. It then discusses basic physics concepts for ultrasound such as velocity, reflectivity, absorption and artifacts. It also covers instrumentation, examination techniques including patient positioning and probe use, and types of scans based on probe position.
B-scan ultrasonography uses high frequency sound waves to produce 2D images of ocular structures. It can be used to evaluate the anterior segment, posterior segment, tumors, vitreous pathology, retinal detachments, and more. The probe transmits sound waves which bounce off tissues and return echoes that are amplified and displayed. This allows visualization of the retina, choroid, lens, vitreous humor and other structures. B-scan is useful for diagnosing and monitoring many ocular conditions.
The document provides information on B-scan ultrasonography. It begins by defining a B-scan as a two-dimensional brightness intensity-modulated display where echoes are shown as dots and stronger echoes appear brighter. It then discusses the basic physics of ultrasound, describing how sound waves are reflected and absorbed in different tissues. The document outlines appropriate techniques for B-scan examinations including patient positioning, probe usage, and methods for localizing structures like the macula. It provides an example of a normal ocular B-scan tomograph and labels key anatomical features.
Ultrasound is a useful tool for evaluating orbital diseases. It uses high frequency sound waves to create images of intraocular and orbital structures. A systematic ultrasound examination involves evaluating the orbital soft tissues, extraocular muscles, and retrobulbar optic nerve. Abnormalities are identified based on changes in location, size, shape, internal reflectivity, and mobility compared to the normal structures. This allows differentiation of various pathologies, such as cysts, masses, muscle thickening, and optic nerve swelling. A comprehensive ultrasound examination provides valuable information for diagnosing and monitoring orbital diseases.
Ocular Ultrasound is an ultrasound for eyes that uses high frequency sound waves to get detailed pictures of your eye and it's orbit. This procedure is usually done by Ophthalmologists.
This document provides an overview of B-scan ultrasonography. It begins with an introduction to B-scans and their use in providing qualitative and quantitative assessment of the eye and orbit. It then discusses the physics and principles behind ultrasound, including reflection, absorption, resolution and other key concepts. The document outlines the components and use of B-scan ultrasound machines, including different probe orientations and scanning techniques. It concludes with clinical applications and indications for B-scan ultrasonography in evaluating ocular pathology.
This document provides information on imaging techniques used to examine the eye and orbit, including normal anatomy. It discusses plain radiography, dacryocystography, angiography, ultrasound, CT, and MRI. For each technique, it describes the procedure, indications, advantages, limitations, and provides examples of normal and abnormal findings. Ultrasound is discussed in more depth, covering techniques, examination of structures like the lens and vitreous, color Doppler, and indications for ocular ultrasound including both congenital and acquired pathologies.
Ultrasonography, also known as B-scan, was first used in ophthalmology in the 1940s. It uses high frequency sound waves to generate images of the inside of the eye. B-scans can be used to evaluate conditions like tumors, retinal detachments, and vitreous opacities. The document discusses the history, physics, principles and various applications of B-scan ultrasonography for examining the eye. Key aspects covered include probe orientation, scan types, interpretation of echogenicity and advantages in providing a non-invasive evaluation of intraocular structures.
This document discusses ultrasonography in ophthalmology. It defines ultrasonography as using acoustic waves with frequencies greater than 20kHz. The main advantages of ultrasonography in ophthalmology are that it is easy to use, involves no ionizing radiation, allows for excellent tissue differentiation, and is cost-effective. The primary uses in ophthalmology are for evaluating the posterior segment in hazy media, detecting intraocular and orbital lesions or foreign bodies, and performing ocular biometry for intraocular lens power calculation. The document describes the basic components of ultrasonography machines and provides examples of A-scan and B-scan display modes and various scanning positions and techniques.
Videokeratography uses a video camera to capture images of the corneal reflection of illuminated rings placed in front of the eye. This allows measurement of the entire corneal contour rather than just a few points like with a keratometer. The images are analyzed by a computer to generate corneal topography maps showing the dioptric power or elevation across the surface. These maps can detect conditions like keratoconus and pellucid marginal degeneration by their characteristic patterns of steepening and assist in monitoring refractive surgery outcomes and contact lens fitting. Keratoconus commonly shows an initial inferior steepening that progresses rotationally.
A-scan biometry is an ultrasound test used to measure the length of the eye, which is important for determining treatments for sight disorders. It works by emitting a sound beam into the eye and measuring the echoes that bounce back from different structures. The measurements of axial length, corneal curvature, and estimated lens position are used to calculate the ideal intraocular lens power needed after cataract surgery. Accuracy is important as even small errors in measurement can significantly impact the calculated lens power. Different formulas exist to relate the biometry measurements to the appropriate lens power, with newer regression formulas found to be most accurate.
This document provides an overview of ultrasound principles and techniques for ophthalmic examination. It discusses the history of ultrasound in ophthalmology and describes A-scan, B-scan, and UBM modalities. Examination techniques for evaluating the globe, orbit, and various ocular structures are outlined. Indications for diagnostic ultrasound include evaluating the lens, vitreous, retina, tumors, and more. Clinical examples of pathologies visualized by ultrasound are also presented.
This document provides an overview of B-Scan ultrasonography for ophthalmic imaging. It describes how B-Scan uses high frequency sound waves to generate images of the eye. Key points covered include the basic physics of ultrasound, different scanning techniques used to image the posterior eye segment, examples of images that can be obtained, and pathologies that can be visualized.
Ultrasonography uses high frequency sound waves to produce echoes from interfaces between structures in the eye. It has been used in ophthalmology since the 1950s, originally with A-scan and later developing B-scan technology. Ultrasound can image both clear and opaque ocular tissues. It is useful for evaluating conditions like tumors, retinal detachments, and vitreous hemorrhages. Examination involves different probe orientations and techniques depending on the area of interest. Findings are interpreted based on echo properties like size, reflectivity, and movement.
Thorough knowledge of the indications of various extra oral techniques allows accurate and timely diagnosis of various maxillofacial pathologies. Further, we can arrive at a diagnosis with minimum number of x-rays there by reducing patient exposure to radiation.
Point of Care Ultrasound - Hyperechoic Future in Medical School?cbyrne2014
This document discusses the potential role of point-of-care ultrasound (POCUS) in medical school. It begins with an overview of ultrasound fundamentals and image interpretation. It then examines how POCUS can efficiently address focused clinical questions at the bedside, such as detecting pneumothorax, pleural effusion, and pericardial effusion. Emerging evidence demonstrates POCUS has diagnostic accuracy comparable to other imaging modalities. The document argues POCUS could improve patient care, be a valuable clinical skill, and enhance career satisfaction if physicians receive proper training. It encourages readers to consider incorporating POCUS into their practice.
This document provides recommendations for imaging the orbit and eye. It discusses ultrasound, CT, and MR as modalities for evaluating intraocular lesions and complex orbital structures. Ultrasound is recommended as the first-line modality due its non-invasiveness. CT provides excellent evaluation of bone structures and detection of calcifications. MR offers superior soft tissue contrast for evaluating orbital and intracranial structures. Imaging protocols for CT and MR of the orbit and eye are outlined, including recommended sequences, planes of imaging, and use of contrast. Anatomical diagrams illustrate orbital bones and structures visible on different imaging views.
This document provides recommendations for imaging the orbit and eye. It discusses ultrasound, CT, and MR as modalities for evaluating intraocular lesions and complex orbital structures. Ultrasound is recommended as the first-line modality due its non-invasiveness and availability. CT provides excellent evaluation of bone structures and detection of calcifications. MR offers superior soft tissue contrast for evaluating orbital and intracranial structures. Imaging protocols for CT and MR of the orbit and eye are outlined, including recommended sequences, planes of imaging, and use of contrast. Anatomical diagrams illustrate orbital bones and structures visible on different imaging views.
Ultrasonography uses ultrasound to image tissues within the body. A-scan ultrasonography provides a one-dimensional view of the eye by measuring the echoes of ultrasound waves. It can be used to detect and measure tumors, assess eye structures for IOL calculation, and interpret pathology. The ultrasound is reflected at interfaces between tissues, appearing as spikes on the display. Immersion techniques provide more accurate measurements than contact techniques by avoiding compression artifacts. Limitations include artifacts, small lesions, missed foreign bodies, and misalignment issues.
Basic principles of ocular ultrasonographyRohit Rao
Ultrasound has been used in ophthalmology since the 1950s, with early pioneers developing A-scan and B-scan technologies. A-scan uses amplitude to represent echoes as vertical spikes, while B-scan displays echoes as brightness on a two-dimensional screen. Modes include A-scan for biometry and B-scan for diagnostic imaging. Later improvements included Doppler ultrasound and high-frequency ultrasound biomicroscopy. Ultrasound utilizes acoustic waves and principles of reflection and transmission to generate images of the eye and orbit.
10 Benefits an EPCR Software should Bring to EMS Organizations Traumasoft LLC
The benefits of an ePCR solution should extend to the whole EMS organization, not just certain groups of people or certain departments. It should provide more than just a form for entering and a database for storing information. It should also include a workflow of how information is communicated, used and stored across the entire organization.
These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
The skin is the largest organ and its health plays a vital role among the other sense organs. The skin concerns like acne breakout, psoriasis, or anything similar along the lines, finding a qualified and experienced dermatologist becomes paramount.
Kosmoderma Academy, a leading institution in the field of dermatology and aesthetics, offers comprehensive courses in cosmetology and trichology. Our specialized courses on PRP (Hair), DR+Growth Factor, GFC, and Qr678 are designed to equip practitioners with advanced skills and knowledge to excel in hair restoration and growth treatments.
Lecture 6 -- Memory 2015.pptlearning occurs when a stimulus (unconditioned st...AyushGadhvi1
learning occurs when a stimulus (unconditioned stimulus) eliciting a response (unconditioned response) • is paired with another stimulus (conditioned stimulus)
Summer is a time for fun in the sun, but the heat and humidity can also wreak havoc on your skin. From itchy rashes to unwanted pigmentation, several skin conditions become more prevalent during these warmer months.
Travel vaccination in Manchester offers comprehensive immunization services for individuals planning international trips. Expert healthcare providers administer vaccines tailored to your destination, ensuring you stay protected against various diseases. Conveniently located clinics and flexible appointment options make it easy to get the necessary shots before your journey. Stay healthy and travel with confidence by getting vaccinated in Manchester. Visit us: www.nxhealthcare.co.uk
Breast cancer: Post menopausal endocrine therapyDr. Sumit KUMAR
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
2. B-scan or brightness modulation scan provides two
dimensional images of a series of dots and lines.
B-scan provides the topographic information of
shape, location, extension , mobility, and gross
estimation of thickness of the tissue
2
dr
amresh
kumar
3. HISTORY
It was first used in the field of ophthalmology by Mundt and
Hughes .
Oksala et al reported the sound velocities in the various
components of the eye
Baum and Greenwood came up with two dimensional,
immersion scan
First commercially available B scan was developed by
Coleman et al in seventies
The importance of the instrument and standardization of
technique was emphasised by Karl Ossoinig 3
dr
amresh
kumar
4. Ultrasonography is used for
Biometry (Ascan) for axial length and corneal
thickness measurement.
Standardized Ascan (diagnostic) for the echostructure
assessment.
It is a part of the Bscan in most of the contemporary
machines with cross vector facility.
Diagnostic Bscan (two dimensional) has to be coupled
with the standardized Ascan to arrive at a correct
diagnosis.
Doppler ultrasonography is especially important in
vascular lesions with different blood flow rates. 4
dr
amresh
kumar
5. BACKGROUND
1-2 MHz :abdominal
ultrasound
8-10 MHz :ophthalmic
ultrasound
(b scan)
is best for posterior segment
35-80 MHz: ultrasound
biomicroscopy
best for cornea and anterior
segment 5
dr
amresh
kumar
6. B mode(brightness)
2 D acoustic section
In b scan ultrasonography, an oscillating focussed
sound beam is emitted, passing through the eye
and imaging a slice of tissue , the echoes of which
are represented as multitude of dots that together
form an image on the screen.
Stronger the echo, brighter the dot.
6
dr
amresh
kumar
8. THE PROBE
Bscan probes are thick, with a mark and emit focussed
sound beam at a frequency of 10MHz.
The mark on the Bscan probe indicates beam orientation
so that the area towards which the mark is directed
appears at the top of the echogram on display screen.
Probe tip: the white line on the far left side of display
Echoes to right side of this line –ocular structures
opposite the tip
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kumar
9. Bscan probe can also be put directly on the
anaesthetized globe after applying eye speculum;
but mostly the Bscanning is done transpalpebrum
with slightly increased overall gain.
Pictures obtained with Bscan probe are two
dimensional as compared to Ascan probe.
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amresh
kumar
10. To obtain high quality B scan pictures one must
ensure that
Lesions are placed in the center of the scanning
beam
The beam is perpendicular to the interfaces at the
area of interest
The lowest possible decibel gain consistent with the
maintenance of adequate intensity should be used
to optimize the resolution of images.
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kumar
11. B scan pictures can be obtained by
axial,
transverse and
longitudinal sections.
axial
axial longitudinal
transverse
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amresh
kumar
12. AXIAL SECTION
In axial section the probe is placed over the
anaesthetized cornea and the beam is directed towards the
posterior pole.
In this section there is marked attenuation of the sound
beam due to the crystalline lens in the path so the picture
may not be suitable for macular thickness measurement.
The lens is avoided by placing the probe at the limbus and
it is 9.00 P position in the right eye and 3.00 P position in
the left eye.
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kumar
13. AXIAL SECTION:
Axial section:
The patient fixates in the primary gaze and the
probe is placed on the globe and directed axially.
Depending on the clock hour location of the
marker, axial-horizontal, axial-vertical and axial
oblique pictures are obtained.
These sections demonstrate lesions at the
posterior pole and the optic nerve head.
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amresh
kumar
14. TRANSVERSE SECTION:
Transverse section:
The mark is kept parallel to the limbus and probe is
shifted from limbus to the fornix and also sideways.
Produces a circumferential slice through several
meridians
This scan gives the lateral extent of the lesion.
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amresh
kumar
15. LONGITUDINAL SECTION:
Longitudinal section:
The mark is kept at right angle to the limbus towards the
centre of cornea
to determine the antero-posterior limit of the lesion.
Best to determine attachment of membranes to optic
disc
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kumar
16. During the procedure the probe is moved from
limbus to fornix in different clock hour meridians
and the picture seen is of diagonally opposite
meridian as follows:
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amresh
kumar
17. Probe can be moved antero-posteriorly as well as
sideways.
Patient is instructed to fix the gaze so that the
probe is perpendicular to the area being examined
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amresh
kumar
18. For macular screening, the four basic Bscan probe
positions that allow perpendicular sound beam
exposure to the macula are
horizontal axial,
vertical transverse,
longitudinal and
vertical macula approaches.
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amresh
kumar
19. With contact type of scanning there is a dead zone
of about 7.5mm adjacent to the probe, so that the
lesions in this region are missed.
To visualize this area, one can keep the probe on
the opposite side at right angle or use immersion
scan technique.
dead
zone
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kumar
20. TOPOGRAPHIC ULTRASONOGRAPHY
To determine the location, shape and extent of the
lesion
A transverse scan to determine the maximal height
and lateral basal dimension of the lesion
A longitudinal scan is done to determine the
anterior to posterior topographic feature of the
lesion
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amresh
kumar
21. QUANTITATIVE ULTRASONOGRAPHY
Reflectivity :
height of the spike on Ascan
Internal structures:
Homogenous : little variation in spike
Heterogenous : marked variation in spike
A scan probe calibrated for tissue sensitivity
Sound directed perpendicular to the lesion
Sound attenuation (acoustic shadowing): for
calcification, foreign bodies, bones
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amresh
kumar
22. KINETIC ULTRASONOGRAPHY
Motion of a lesion
Within a lesion
Mobility , vascularity and convection movement
Mobility
Change in gaze
PVDs, RDs and choroidal detachments all exhibit their
own distinctive pattern of movement
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kumar
24. USE OF BSCAN:
Some of the common eye conditions where
diagnostic ultrasonography is helpful are:
A. Dense cataract
B. vitreous haemorrhage,
C. leucokoria
D. vitritis/endophthalmitis
E. painful blind eye
F. before penetrating keratoplasty
G. intraocular tumors
H. oculo-orbital trauma
I. postoperative cases 24
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amresh
kumar
25. DENSE CATARACT
Dense
cataract
marked and
rapid decrease
in visual acuity,
afferent
pupillary
defect,
Rubeosis
iridis
myopia
uveitis
trauma
diabetes
mellitus
Do bscan and look for
1. retinal detachment(RD),
2. intraocular tumor with
calcification,
3. posterior staphyloma,
4. vitreous haemorrhage,
5. asteroid hyalosis,
6. optic nerve head cupping,
7. abnormal growth over optic
nerve head or
8. axial length disparity.
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amresh
kumar
26. USE OF BSCAN
In vitreous haemorrhage,
on echoevaluation one may pick up
retinal tear with detachment,
disciform degeneration,
melanoma,
fibrovascular fronds with tractional RD or
subhyloid haemorrhage.
The cause of leucokoria whether due to
retinoblastoma,
PHPV,
Coat's disease,
Retinopathy of prematurity or
old haemorrhage can be deduced.
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amresh
kumar
27. USE OF BSCAN
In vitritis/endophthalmitis,
it helps in ruling out foreign body (FB) and rupture of
intraocular cyst and
helps in assessing the response to treatment.
In a painful blind eye,
it is indicated to rule out
uveal melanoma,
old RD with chronic uveitis,
intraocular/subretinal cyst,
lens dislocation,
failed RD surgery,
inflamed phthisical eye, e.t.c.
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amresh
kumar
28. USE OF BSCAN
Patients planned for penetrating keratoplasty with
opaque anterior segment.
Patients with clear media
where on indirect ophthalmoscopy suspicious lesions
suggestive of intraocular tumors like
choroidal melanoma,
haemangioma,
metastatic carcinoma,
osteoma, etc are seen.
Orbital screening should be performed in patients with
abnormal choroidal folds and posterior scleritis.
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amresh
kumar
29. USE OF BSCAN
In oculo-orbital trauma,
it is imperative to look for
sclerochoroidal rupture with RD,
intraocular/orbital FB,
lens displacement,
optic nerve avulsion and
orbital haemorrhage.
In postoperative cases to assess
endophthalmitis/toxic anterior segment syndrome,
lens fragment/ intraocular lens(IOL) displacement into
the vitreous cavity,
choroidal detachment/ haemorrhage,
status of retina post RD surgery, etc. 29
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amresh
kumar
30. ECHODESCRIPTION OF COMMON INTRAOCULAR
CONDITIONS:
Vitreous floaters appear as one or more echo dots of
less brightness in the mid /posterior vitreous cavity which
show mobility with after movement display on Bscan.
These may be associated with enlarged globe size.
On Ascan, these echodots have extremely low to low
reflectivity (2-20%) and to appreciate them better overall
gain may be increased by 56db.
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amresh
kumar
31. Vitreous haemorrhage may be fresh, resolving,
organizing, organized with membrane formation
and at times can lead to tractional RD.
To pick up fresh vitreous haemorrhage, the overall
gain can be increased by 10 db.
They appear as multiple fine echo opacities dusting
the vitreous body which do not extend beyond the
posterior vitreous border.
They are usually attached to the retinal surface but
may get detached and are then seen as PVD
(posterior vitreous detachment).
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kumar
32. • In older haemorrhage, the echodots are denser
and show higher reflectivity (up to 60%) on Ascan.
Stained PVD may also be seen.
• In resolving vitreous haemorrhage, in comparison
with older scans, echodots on Bscan show
decrease in brightness and numbers.
Stained PVD
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amresh
kumar
33. SUBHYALOID HAEMORRHAGE
Subhyaloid haemorrhage is situated typically at
the posterior pole between the anterior surface of
retina and posterior vitreous face.
It may be fluid in nature or may get organized.
Sometimes an organized old pre-retinal
haemorrhage may be seen in all the quadrants of
the globe.
Lifting of this organized vitreous haemorrhage
during vitrectomy can produce iatrogenic retinal
breaks and retinal detachment.
33
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amresh
kumar
34. An old organized vitreous haemorrhage can result
in vitreous-membrane formation (seen as
echogenic lines on Bsan) mimicking RD.
The attachment of the echomembrane on/upto the
optic nerve head and Quantitative echography
II(difference in decibel setting 6-15db for retina and
>20 db for vitreous membrane) help to differentiate
RD from vitreous membranes.
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amresh
kumar
35. ENDOPHTHALMITIS
The inflammatory cells are seen dotlike on Bscan,
These are multiple, scattered diffusely or
may be localised to the anterior, mid or the posterior
one third of the vitreous cavity depending on the
etiology.
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amresh
kumar
36. On A scan, these dot like opacities show low to
medium reflectivity (10-60%).
It is not possible to differentiate vitritis from vitreous
haemorrhage in still pictures unless clinical details
are available.
These inflammatory cells organize very rapidly to
form vitreous membranes and therefore frequent
examinations should be performed.
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amresh
kumar
37. ASTEROID HYALOSIS
It is characterized clinically by presence of calcium
crystals embedded in an amorphous matrix on Bscan
It appears as multiple, densely packed, homogeneously
distributed echodense dots of medium to high reflectivity
(50-100%)
These are usually localized to the core of vitreous body.
One may find clear retrovitreal or pre-retinal space
37
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amresh
kumar
38. POSTERIOR VITREOUS DETACHMENT (PVD):
PVD is seen as echogenic membrane concentric to the
globe, infront of the retinochoroidoscleral complex with clear
subvitreal space.
It may be small, interrupted, peripheral or continuous and
total.
If lined with red blood cells its echo density increases.
On A scan, the reflectivity of this membrane is low if the
PVD is thin but it may be high if it is thick and lined with red
blood cells.
PVD usually does not show attachment to the optic nerve
head.
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amresh
kumar
39. RETINAL DETACHMENT
Retinal detachment means separation of
neurosensory retina from the pigmentary retina.
It may be total/subtotal, localized/peripheral or
fresh/old with proliferative vitreoretinopathy(PVR)
changes.
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amresh
kumar
40. On Bscan, it appears as echogenic dense
membrane, biconvex or biconcave with 100%
attachment at the optic nerve head (ONH)
and 90-100% reflectivity on Ascan.
Attachment at ONH is not seen in localized,
peripheral RD where membrane is visible
only in a single quadrant.
In uncomplicated cases, there is a clear
space between the detached retina and the
ocular coat spike indicating transudative
nature of the subretinal fluid.
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amresh
kumar
41. Fine echodots may also be seen in the subretinal
space indicating the presence of haemorrhage or
debris.
In PVR cases, vitreous body shows debris dots or
membrane formation depending upon its grade
and cystic degeneration may be present in an old
RD.
After movement if present is suggestive of fresh
RD.
In rhegmatogenous RD, retinal tears especially
operculated tears/ giant tears and even the trickle
of vitreous haemorrhage from the break site into
the vitreous cavity may be picked up.
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amresh
kumar
42. In tractional RD, fibrovascular frond within the
vitreous cavity or along the vitreous face may be seen.
This frond when exerts tractional force on the retina,
produces tent like elevation from the retina as an
echogenic membrane which may be localized or
extensive enough to become total.
It does not show after-movement and vitreous cavity
may show evidence suggestive of old haemorrhage.
On Ascan this thick membrane produces 100%
reflectivity.
At times thick vitreous may be difficult to differentiate
from RD as it may have an attachment to the ONH
and Quantitative echography II may be used to
differentiate the two
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amresh
kumar
43. SCLERAL EXPLANTS
Scleral Explants are used in rhegmatogenous RD
surgeries where buckle or sponge is applied to
indent the globe.
On Bscan they appear as echogenic spots with the
globe indentation towards the vitreous body and
echolucent spot (shadowing) behind the scleral
explant.
The explant shows high reflectivity on Ascan.
Silicone buckle is less echodense in comparison to
the sponge.
Silicon
buckle
sponge
Scleral erosion
43
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amresh
kumar
44. VITREOUS EXPANDERS
Vitreous expanders like silicone oil or perfluorocarbons
may be seen in operated RD cases.
Emulsified silicone oil produces marked sound
attenuation hindering the visualization of posterior
segment.
It also results in a larger vitreous cavity which is
relatively echofree.
Perfluorocarbons on the other hand show multiple,
highly reflective liquid bubbles in the posterior vitreous
Emulsified silicone oil Perfluorocarbons
44
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amresh
kumar
45. CHOROIDAL DETACHMENT
Choroidal detachment is usually in the
periphery and may be localized or total.
It is seen as dome shaped elevation with clear
sub choroidal space on Bscan
and 90-100% double peaked tall spike on
Ascan.
There is none or very little after movement on
kinetic echography.
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amresh
kumar
46. CHOROIDAL DETACHMENT
In cases with impending expulsive
haemorrhage or traumatic choroidal
detachment, the sub choroidal space shows
haemorrhage as multiple dot like opacities on
Bscan.
There may be two or more domes which may
meet in the vitreous cavity to form kissing
choroidals.
360 degree detachment shows pathognomic
scalloped appearance
46
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amresh
kumar
48. Retinal tear
Retinoschisis:
Moderately elevated thin membrane shaped echo
Retinal tear with free
superior end
Vitreous attached to the
tear
tear
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dr
amresh
kumar
49. INTRAOCULAR TUMORS
Intraocular tumors which commonly require Bscan
evaluation are
retinoblastoma,
choroidal melanoma,
hemangioma,
metastasis,
diktyoma and
Osteoma
Bscan helps in measurement of tumour dimensions,
differentiation ,extrascleral extension, size , assessing
tumour growth or regression
help in distinguishing solid from cystic lesions
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amresh
kumar
50. RETINOBLASTOMA
Retinoblastoma is seen as a solid tumor arising
from the retinal layer obliterating the vitreous
cavity.
Calcification within the tumor mass is typical of
retinoblastoma.
There may be shadowing effect behind the lesion
in the orbital mass.
Concomitant RD may be sometimes present.
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amresh
kumar
51. RETINOBLASTOMA
On A scan, spikes with moderate internal
reflectivity may be seen
but in presence of necrosis and calcification,
highly reflective, irregular spikes are observed.
Sound attenuation is moderate to high.
The globe is usually normal in size except in
glaucomatous stage when it becomes enlarged,
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amresh
kumar
53. In persistent hyperplasic primary vitreous,
the globe size may be smaller and
the vitreous cavity shows persistence of the primary
vascular system seen as echo membranous track from
optic nerve head to the back of the lens
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amresh
kumar
54. RETINOPATHY OF PREMATURITY
Retinopathy of prematurity
is characterised by multiple vitreous membranes and
RD in the periphery.
The size of the globe may be smaller in these cases.
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amresh
kumar
55. COAT'S DISEASE
In Coat's disease there is unilateral involvement
and
there may be presence of an exudative RD with
turbid subretinal fluid or cholesterol crystals in the
subretinal space.
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amresh
kumar
56. Choroidal naevus/melanoma appears as a small
dome shaped, localized, solid lesion, elevated from
the ocular coats with low to medium reflective Ascan
spike (40-60%).
Collar stud pattern/ mushroom appearance
Regular internal structure, acoustic shadowing, internal
vascularity
Tuberculoma may have a similar appearance on
Bscan.
Collar stud pattern/ mushroom pattern
Tumour with RD
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amresh
kumar
57. RUPTURED GLOBE
In a ruptured globe with low intraocular pressure,
there may be scleral dehiscence with vitreous
haemorrhage, vitreous/uveal tissue prolapse or
vitreous haemorrhage with RD.
Scleral dehiscence usually occurs at the site of
extraocular muscle insertion and may be concentric
to the limbus.
In cases of small scleral rupture, a trickle of
haemorrhage into the vitreous cavity is noticed on
Bscan.
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amresh
kumar
58. HAEMOPHTHALMOS
Hyphaema, vitreous haemorrhage with choroidal
haemorrhage and scleral rupture with orbital
haemorrhage may be seen in combination and the
condition may appear as haemophthalmos.
Black eye (lid haemorrhage) may coexist with it.
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amresh
kumar
59. Posteriorly dislocated crystalline lens into the vitreous
cavity
It is seen as a biconvex body which may be mobile or fixed.
Lens fragment in vitreous usually produces vitritis.
The intraocular lens in vitreous cavity appears like a FB and
shows high reflectivity and shadowing effect behind it.
intraocular lens
crystalline lens
Lens fragment
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amresh
kumar
60. PHTHISIS BULBI
Phthisis bulbi
The globe is small, soft, deshaped and
There is thickened retinochoroidal complex.
Intraocular calcification or bone formation may
occur in choroidal layer in long standing cases
which is better appreciated on decreasing the gain
by 15-20db.
Retro globe shadowing may also be visible.
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amresh
kumar
61. IOFB
IOFB are seen as echodense spots with a 100%
reflectivity on Ascan spike irrespective of the nature
of the FB and
ultrasonography enables its exact sizing and
localization.
Shadowing effect is usually seen.
Decreasing the gain on the machine by 10db helps
in differentiating it from dense blood clot and lens
fragment.
Also, shadowing is not seen with lens fragments. 61
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kumar
62. IOFB
Foreign bodies less than 0.2mm in size and
those in the orbit which are obscured by
haemorrhage are best picked up by CTscan.
Spherical FB like gunshot pellets, have an
anterior and posterior surface and between them
there are multiple internal reverberations/echoes.
These echoes are seen as echogenic opacities
with a wedge shaped trail of spikes.
The trail disappears on decreasing the overall
gain of machine but the initial echodense spot
remains as such
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amresh
kumar
63. OPTIC NERVE EVALUATION
general topography ,relationship to structures ,
optic disc anomalies and alteration in contour of the
globe
the subarachnoid space surrounding optic nerve
appears as echoluscent crecentric or circle around
the nerve called ‘ DOUGHNUT SIGN
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amresh
kumar
65. Retinal coloboma
is a congenital abnormality seen in the inferonasal
quadrant as defect in the retinochoroidal layer of the
globe on Bscan.
Optic disc coloboma :
If the coloboma involves the ONH region, there is
absence of ONH.
Optic disc coloboma
65
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amresh
kumar
66. POSTERIOR STAPHYLOMA
Posterior staphyloma is a common finding
observed in high myopes.
It appears as a sudden bowing backward of the
globe with thinning of the retinochoroidal layer.
It is usually seen at the posterior pole and the axial
length of the globe is increased, indicating axial
myopia.
There may be presence of vitreous debri.
Posterior staphyloma
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amresh
kumar
67. POST OPERATIVE ENDOPHTHALMITIS
Post operative endophthalmitis can be
differentiated from toxic anterior segment syndrome
(TASS).
In TASS, the severe inflammation is visible only in
the anterior segment whereas
In endophthalmitis there is severe vitritis and
exudation in the vitreous cavity.
Also, Bscan is useful in evaluating the response to
intravitreal injection in endophthalmitis
67
dr
amresh
kumar
68. Cysticercosis
It can occur in any ocular tissue.
It is more common in vitreous cavity, subretinal space
and sub conjunctival space but other sites like
extraocular muscles and optic nerve may also be
involved.
Bscan reveals a well defined cystic lesion with clear
contents and a hyperechoic area suggestive of scolex.
Serial echography helps in followup of the patient and
resolution is indicated by disappearance of the scolex.
scolex
Cystic
lesion
68
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amresh
kumar
69. Posterior scleritis :
T-sign collection of fluid in sub tenon space
T-Sign in posterior scleritis 69
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amresh
kumar
70. Reverberation artefacts
insufficient coupling fluid(i.e. lack of methyl
cellulose)
entrapment of air between the probe and eye
display of bright echoes which represent multiple
signals
ANGLE OF INCIDENCE ARTEFACT
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amresh
kumar