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What is
Ultrasound?

Alternate terms: ocular sonography, opthalmic ultrasonogrphy.
 
Ophthalmic ultrasound is a diagnostic medical imaging field that utilizes high frequency sound waves to create cross-section B-scan images and Time-Amplitude A-scan images of the globe and orbit. 
 
Interpretation of the images is based on knowledge of both the normal and abnormal ocular anatomy, and an understanding of the physical principles of ultrasound. While the technique is relatively easy to learn, significant practice is required to feel comfortable diagnostically. 
 
Over the years, diagnostic ultrasound has been utilized for opaque ocular media situations or evaluation of tumors within the globe and orbit. Recent advances have expanded the use to include interpretation of clear media involving the status and position of the vitreous. 
 
This website is focused predominately on B-scan pattern recognition of ocular and orbital abnormalities in the hope of accelerating the education of those interested in this noninvasive imaging technique.
 

Our Essential Lectures in Ophthalmic Ultrasound is a great place to review the basics of how ultrasonography has and can be used in ophthalmic applications or see below for the full list.

Title

1a: An Introduction

Oct 6, 2009

Dr. Yale Fisher introduces his series of Essential Lectures on Ophthalmic Ultrasound.

See Full

1b: A Brief History of Ultrasound

Sep 22, 2009

Dr. Yale Fisher discusses the origins of this imaging modality in this installment of Essential Lectures.

See Full

2: Basic Physical Principles of Ultrasound

Sep 22, 2009

Dr. Yale Fisher discusses the basic physical principals that make ultrasound possible in this installment of Essential Lectures.

See Full

3: Basic Instrument Design

Sep 22, 2009

Dr. Yale Fisher discusses the Basic Instrument Design of the typical Ophthalmic Contact B-Scan ultrasound machine in this installment of Essential Lectures.

See Full

4: How Does an A-Scan Become a B-Scan?

Sep 22, 2009

Dr. Yale Fisher discusses how an A-Scan becomes a B-Scan in this installment of Essential Lectures.

See Full

5: Examination Techniques for the Beginner

Sep 22, 2009

Dr. Yale Fisher discusses examination techniques for the beginner in this installment of Essential Lectures.

See Full

6a: Concepts for Diagnosis - Real Time

Sep 22, 2009

Real Time

See Full

6b: Concepts for Diagnosis - Gray Scale

Sep 22, 2009

Gray Scale/Simultaneous A-Scan

See Full

6c: Concepts for Diagnosis - 3D

Sep 22, 2009

3-D Thinking

See Full

7: How to Approach a Diagnosis?

Sep 22, 2009

How to Approach a Diagnosis?
Dr. Yale Fisher discusses his approach to making a diagnosis using Contact B-Scan Ultrasound in this episode of Essential Lectures.

See Full

8: Vocabulary

Dec 14, 2009

Vocabulary
 
This lecture covers some of the key terms and concepts used in Ophthalmic Ultrasound.
 
 

See Full

Acute Partial Vitreous Separation

Mar 3, 2010

This is a partial vitreous separation that demonstrates a mildly reflective curvilinear shape of the partially separated vitreous face. The vitreous is attached inferonasally and inferotemporally, but detached and freely mobile at 6 ... See Full

Asteroid Hyalosis, Posterior Vitreous Separation

Sep 26, 2009

In asteroid hyalosis, accumulations of calcium soaps dispersed throughout the vitreous produce bright echoes in the usually echolucent vitreous. The appearance of asteroid hyalosis should not be confused with that of vitreous hemorrhage or ... See Full

Asteroid Hyalosis, Vitreous Face Attached

Sep 27, 2009

In asteroid hyalosis, accumulations of calcium soaps dispersed throughout the vitreous produce bright echoes in the usually echolucent vitreous. The appearance of asteroid hyalosis should not be confused with that of vitreous hemorrhage or ... See Full

Attached Vitreous With Floaters

Feb 22, 2011

The vitreous is attached and demonstrates aftermovements of formed vitreous as the patient is asked to look to the right and left.  There is mild reflectivity in the formed vitreous from collagen. The optic nerve is visible in the ... See Full

Choroidal Hemangioma

Jan 25, 2011

In this movie an elevated, dome like, mass of the choroid with high reflectivity throughout the lesion and mild shadowing of the orbital fat behind the tumor can be seen.
 
This movie contributed by: Cynthia ... See Full

Communicating Orbital Cyst

Feb 2, 2010

Observe orbital cystic structures temporal to optic nerve.
Orbital cyst transmits sounds easily. Small optic nerve shadow is visible superior to the cyst in the upper portion of the screen. Strong reflections from choroidal region are ... See Full

Communicating Orbital Cyst

Sep 25, 2009

Tilting of the probe vertically demonstrates communication (green arrow) of the orbital cyst (yellow arrows) to the vitreous cavity as well as posiible communication to optic nerve (orange arrow). 
Orbital cyst transmits sounds ... See Full

Complete PVD

Dec 22, 2010

This is a sagittal view of a complete posterior detachment demonstrated by the thin preretinal reflection (yellow arrow).  Scleral depression (green arrow) at the ora serrata demonstrates the ability to register ... See Full

Dislocated Intraocular Lens On Retina

May 31, 2011

An intraocular lens (IOL) implant can dislocate posteriorly and appears as a large foreign body within the vitreous cavity. The IOL demonstrates shadowing within the orbit.
 
This movie contributed by: Dr. Yale ... See Full

Dislocated Lens

Mar 3, 2010

This is a dislocated lens.
You can see a large ovoid object resting against the ocular wall shadowing the orbital fat. Internal reflectivity demonstrates a nucleus within the larger ovoid structure. Moderate reflections from the ... See Full

Dislocated lens

Sep 25, 2009

Dislocation of the lens into the vitreous can be easily detected by ultrasound. The lens is an extremely good reflector of sound. Its characteristic oval shape and acoustic shadowing qualities present a classic image. Voluntary movement of the ... See Full

Encircling Sclearal Buckle Axial View

Sep 25, 2009

Rotation vertically demonstrates a superior and inferior cross-section of a highly elevated scleral buckle. Movement of the formed vitreous separated and far anterior (visible at the left of the screen). Optic nerve shadow is visible as the ... See Full

Encircling Sclearal Buckle Axial View

Feb 2, 2010

The buckle is an encircling element. The anterior posterior view shows a cross section above and below on the screen. 
Rotation vertically demonstrates a superior and inferior cross-section of a highly elevated scleral buckle. There ... See Full

Hypotony, Thickend Choroid, Total Retinal Detachment, Foreshortened Globe

Sep 25, 2009

No motion of a central vitreous stalk-like change coming from the optic nerve to the anterior portion of the eye, which is at the left of the screen.
Mild reflectivity of the stalk is noted because the beam is not perpendicular to the ... See Full

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