[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Ophthalmology](https://durgical.com/en/ophthalmology/) › [The eye exam](https://durgical.com/en/ophthalmology/areas/exam/) › Ocular ultrasound and point-of-care scanning # Ocular ultrasound and point-of-care scanning - Examination When blood or cataract hides the retina, ultrasound through the closed lid shows detachment, bleeding, a dislocated lens or a foreign body. Updated Nov 5, 2026 **See it in 3D:** [Vitreous](https://durgical.com/en/anatomy/vitreous-body/) · [Retina](https://durgical.com/en/anatomy/retina/) · [Lens](https://durgical.com/en/anatomy/lens/) · [Optic nerve](https://durgical.com/en/anatomy/optic-nerve/) ## Key points - Tethered to the disc = retinal detachment. - Mobile swirling echoes = vitreous haemorrhage or PVD. - Closed lid, lots of gel, no pressure. - Wide optic nerve sheath = raised intracranial pressure. ## What it is Ocular ultrasound (B-scan) images the inside of the eye through the closed eyelid. Ophthalmologists use it when the view of the fundus is blocked. In the emergency department, point-of-care ultrasound with a linear probe can identify retinal detachment, vitreous haemorrhage, posterior vitreous detachment, lens dislocation, an intraocular foreign body and retrobulbar haemorrhage, and measure the optic nerve sheath diameter as a sign of raised intracranial pressure. ## Normal values and scales - Retinal detachment: a bright membrane that stays tethered to the optic disc and moves little. - Posterior vitreous detachment and vitreous haemorrhage: fine, mobile echoes that swirl with eye movement and are not tethered to the disc. - A wide optic nerve sheath (in adults roughly over 5 mm) suggests raised intracranial pressure. - A dislocated lens appears in the vitreous cavity; a metallic foreign body gives a bright echo with a shadow behind. ## How it is done - Ask the patient to close the eyes; cover the lid with a thick layer of gel or a protective film. - Rest the hand on the patient's face and place the linear probe on the gel without pressing on the eye. - Scan in transverse and longitudinal planes, sweeping through the globe. - Ask the patient to move the eye from side to side to see whether structures move (dynamic exam). - Measure the optic nerve sheath about 3 mm behind the globe if raised intracranial pressure is a question. ## How to interpret it - Ultrasound is avoided or done with no pressure at all when an open globe is suspected; CT is preferred. - A normal ultrasound does not exclude a small peripheral retinal tear. - The optic nerve sheath measurement supports, but does not replace, imaging of the brain. ## Next step / Initial management - Membrane tethered to the disc: same-day ophthalmology for retinal detachment. - Vitreous haemorrhage: same-day ophthalmology to exclude a retinal tear or detachment behind it. - Wide optic nerve sheath with headache or reduced consciousness: urgent brain imaging. - Suspected intraocular foreign body: CT of the orbits and emergency referral. ## Test yourself Think of the answer, then tap the question to see it. ## How is retinal detachment told apart from vitreous detachment on ultrasound? A retinal detachment stays tethered to the optic disc and moves little; vitreous detachment and haemorrhage move freely and are not attached to the disc. ## When should ocular ultrasound be avoided? When an open globe is suspected, because pressure on the eye can worsen the injury; CT is used instead. ## What does a wide optic nerve sheath suggest? Raised intracranial pressure. [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/ophthalmology/ocular-ultrasound-and-point-of-care-scanning/) ## Connections ## See it in 3D 4 The structures of Durgical's 3D anatomy where it is found. - [Vitreous](https://durgical.com/en/anatomy/vitreous-body/) - [Retina](https://durgical.com/en/anatomy/retina/) - [Lens](https://durgical.com/en/anatomy/lens/) - [Optic nerve](https://durgical.com/en/anatomy/optic-nerve/) ## Related 4 - [Retinal detachment: how fast to refer](https://durgical.com/en/ophthalmology/retinal-detachment-how-fast-to-refer/) - [Floaters and flashes](https://durgical.com/en/ophthalmology/floaters-and-flashes/) - [Suspected open globe: the first steps](https://durgical.com/en/ophthalmology/suspected-open-globe-the-first-steps/) - [The swollen optic disc: papilloedema or not](https://durgical.com/en/ophthalmology/the-swollen-optic-disc-papilloedema-or-not/) ## Related conditions 3 - [Retinal detachment](https://durgical.com/en/conditions/retinal-detachment/) - [Raised intracranial pressure and brain herniation](https://durgical.com/en/conditions/raised-intracranial-pressure-and-brain-herniation/) - [Ocular trauma: hyphema and open globe injury](https://durgical.com/en/conditions/ocular-trauma-hyphema-and-open-globe-injury/) [← All of ophthalmology](https://durgical.com/en/ophthalmology/) Educational content; not a clinical guideline and no substitute for assessment by a health professional. For sudden visual loss, severe eye pain, a chemical burn or an eye injury, go to an emergency department at once. Sources: [Point-of-Care Ocular Ultrasound](https://www.ncbi.nlm.nih.gov/books/NBK459120/) (StatPearls Publishing (NCBI Bookshelf), 2026); [Retinal Detachment](https://www.ncbi.nlm.nih.gov/books/NBK551502/) (StatPearls Publishing (NCBI Bookshelf), 2024). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/ophthalmology/ocular-ultrasound-and-point-of-care-scanning/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/ophthalmology/ocular-ultrasound-and-point-of-care-scanning/