Diagnosis of periorbital gas on ocular ultrasound after facial trauma
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Fig. 1
Note the significant swelling of the left upper eyelid.
Fig. 2
The eye is seen through the lower lid. Air in the middle of the swollen upper lid is seen as bright reflectors (arrows) and casts a large dirty shadow blocking all useful information deep to it. A indicates anterior chamber; G, globe; arrow, lens.
Fig. 3
The eye is seen with the lens anterior, at the top of the image. The singe arrow points to a bright area that represents the air. Dirty shadowing is seen behind the air (arrows) similar to that seen from bowel gas in abdominal ultrasound.
Abstract
Ocular trauma can occur from isolated facial trauma or in major blunt trauma such as motor vehicle accidents or falls. Despite the etiology of the injury, a thorough evaluation is important but may often be difficult if severe swelling is present. Recently, emergency ultrasound has seen the use of ocular ultrasound to evaluate visual changes and trauma. Literature suggests that unsuspected and difficult to diagnose pathology may be easily detected on ultrasound of the orbit. We present 3 cases of isolated facial trauma in which routine evaluation with ocular ultrasound led to the discovery of periorbital air with one patient having air insufflating the upper lid of the affected side.
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