A 71 year-old female presented with painless unilateral vision loss. She reported flashing lights in her right visual field three days prior, followed by loss of vision in the right nasal field. Ultrasound of her eye revealed the following:
These images demonstrate a retinal detachment, or a tear in the retinal epithelium. Timely diagnosis is critical, given the risk for permanent monocular vision loss. Our initial exam was concerning for retinal detachment, however one must also consider other etiologies in the differential- vitreous detachment, vitreous hemorrhage, inflammation, or even foreign body in the setting of trauma.
Often, a dilated fundoscopic exam in the Emergency Department may not be possible, so ultrasound can be useful to quickly identify pathology. By using a high-frequency linear probe resting gently over a closed eye, the retina will appear as an undulating hyperechoic membrane, tethered to the posterior aspect of the eye at the optic disc- which is a finding that can assist in differentiating retinal detachment from vitreous detachment.