Limited Ocular US

Image Review

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Case From AIUM

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“I Have Red Jelly In My Eye”

A Case That Was Not Lost In Translation

Matt Jones MD, Don Byars MD, Kean Feyzeau MD, Thomas Hogan DO, Rebecca Dray MD

No Disclosures.

Disclosures

Acknowledgements

A 41-year-old male presented to the emergency room with a chief complaint of "red jelly" in his right eye. He was primarily Spanish-speaking and had a history of poorly controlled diabetes, hyperlipidemia and obesity. He stated that he woke up with red jelly in his right eye approximately one day prior to presentation. He denied any history of trauma, pain, prior eye surgeries or eye problems.

The Case: History

On visual inspection the eye was grossly normal. There were no obvious traumatic findings, injection or discharge. There was full function of ocular muscles without pain. Pupils were equal and reactive to light. The patient could see movement in all visual fields but was unable to distinguish fingers on the right. Visual acuity was 20/20 OS and unobtainable on the right. Intraocular pressures were 10 OS and 12 OD with no uptake on fluorescein staining.

The Case: Physical Exam

Conclusions

• The case was discussed with the ophthalmology team and the patient was quickly evaluated. Per the consult note, the left eye demonstrated severe proliferative diabetic retinopathy and the right eye had significant vitreous hemorrhage. An additional A-mode scan of the right eye was also completed by ophthalmology confirming a posterior vitreous detachment.

• Ocular point-of-care ultrasound can be used quickly, safely and effectively as a diagnostic tool that can aid in timely patient care and disposition. This particular case is an excellent example of how critical ocular pathology can be identified within minutes of initial presentation.

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EVMS Emergency Ultrasound

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