Post-Blunt Ocular Trauma Exams Benefit From Ultrasound Biomicroscopy

Post-blunt ocular trauma examinations may be improved with the application of ultrasound biomicroscopy (UBM) to evaluate hidden anterior segment pathologies, according to a study presented at the Association for Research in Vision and Ophthalmology (ARVO) conference held April 23-27, 2023, in New Orleans. The research also shows the value of adding a modern balloon technique to these patients’ workup protocol.

The anterior segment of the eye can incur significant damage from blunt ocular trauma. As such, appropriate evaluation and treatment is essential for preventing visual impairment and long-term effects from damage. However, post-trauma evaluations may be impeded by media opacity, hypotony, distorted anatomy, and pain, complicating patient compliance for examination.

This study was designed to assess the utility of UBM for evaluating post-blunt ocular trauma. Patients (N=42) who experienced blunt trauma underwent a comprehensive ocular examination with posterior segment echography plus UBM on the day of their injury at the Tel Aviv University Sackler Faculty of Medicine in Israel. The UBM examination was conducted using a water-filled balloon technique without an eye cup on the Aviso S or ABSOLU instrument (Quantel Medical).

The patients were aged mean 38±22.4 years, 30 were men, and 12 were women.

During UBM, most post-blunt ocular trauma eyes had angle recession (64%) and hyphemia (57%), many had microhyphema (31%), choroidal thickening (11%), and iridodialysis and ciliary body cleft (9.5%), and few had subluxation (2.5%).

No choroidal and ciliary body abnormalities were identified during the clinical examination.

All eyes with choroidal and ciliary body findings (100%) and most eyes with angle recession (74%) observed using UBM had posterior segment pathologies. In this study, UBM was found to have clinical utility in post-blunt ocular trauma examination. These findings led the study authors to conclude, “UBM is effective in identifying abnormalities that may not be visible on clinical examination and can provide valuable information surgical planning and therapeutic management.” The researchers also report that “The balloon technique, which is easy to use, sterile, and non-invasive, can improve diagnostic accuracy and is suitable for use in recently traumatized eyes.”

This study may have been limited by not including follow-up data.