Acute Traumatic Cataract Diagnosed by Ocular Point of Care Ultrasound (POCUS) in the Emergency Department

TL;DR

This case study shows how emergency doctors used ultrasound to quickly diagnose a traumatic cataract in a patient after a bike accident.

Contribution

Demonstrates the utility of ocular POCUS in diagnosing traumatic cataract in the emergency department.

Findings

POCUS identified traumatic cataract when CT and external exam were inconclusive.

Use of POCUS avoided unnecessary tests and expedited specialist care.

Supports training emergency physicians in ocular POCUS for trauma cases.

Abstract

It is estimated that over 55 million people suffer ocular injuries each year. Of these injuries, approximately 1.6 million are found to suffer permanent visual impairment secondary to traumatic cataract. Although a traumatic cataract can be a vision threatening pathology, it may be overlooked or difficult to diagnose. The objective of this report is to demonstrate the utility of ocular point of care ultrasound (POCUS) in the emergency department while highlighting its potential to diagnose a traumatic cataract. Case

A 66-year-old man presented to the emergency department with suspected cervical spine injury after being involved in a bicycle accident. During the secondary survey, the patient developed sudden painless loss of vision in his left eye. Computed tomography (CT) and external ocular exam did not reveal the cause of his vision loss. Emergency physicians employed the use of point of care ultrasound POCUS to diagnose an acute traumatic cataract as the etiology, which was later confirmed by Ophthalmology.

With the adoption of ocular POCUS as a staple in emergency medicine residency training, this case is testimony to its growing functionality in the setting of ocular trauma. We pose that it may aid as a diagnostic tool, avoid gratuitous testing, and ultimately expedite specialist evaluation and definitive treatment.

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