Monocular Painless Vision Loss in the Emergency Department: Multipurpose Utility of Point-Of-Care Ultrasound

Authors

Roger Chirurgi, Department of Emergency Medicine, New York Medical College, Metropolitan Hospital Center, New York, New York.
Anisha Duvvi, Albert Einstein College of Medicine, Bronx, New York.
Bisma Hussain, Department of Emergency Medicine, New York Medical College, Metropolitan Hospital Center, New York, New York.
Lucy Li, Department of Ophthalmology, New York Medical College, Metropolitan Hospital Center, New York, NY.
Jaspreet Singh, Department of Emergency Medicine, New York Medical College, Metropolitan Hospital Center, New York, New York.
Abaynesh Haftu Nigussie, Department of Emergency Medicine, New York Medical College, Metropolitan Hospital Center, New York, New York.
Ahmed Hashmi, Department of Emergency Medicine, New York Medical College, Metropolitan Hospital Center, New York, New York.
Estrella Roffe, Department of Emergency Medicine, New York Medical College, Metropolitan Hospital Center, New York, New York.
Sonja Jauhal, Department of Emergency Medicine, New York Medical College, Metropolitan Hospital Center, New York, New York.
Misagh Fasazadeh, Department of Emergency Medicine, New York Medical College, Metropolitan Hospital Center, New York, New York.
Hossein Kalantari, Department of Emergency Medicine, New York Medical College, Metropolitan Hospital Center, New York, New York.
Getaw Worku Hassen, Department of Emergency Medicine, New York Medical College, Metropolitan Hospital Center, New York, New York.Follow

Author Type(s)

Faculty, Resident/Fellow

DOI

10.1016/j.jemermed.2023.10.011

Journal Title

The Journal of Emergency Medicine

First Page

192

Last Page

196

Document Type

Article

Publication Date

2-1-2024

Department

Emergency Medicine

Second Department

Ophthalmology

Abstract

BACKGROUND: Eye-related symptoms are a common presentation in the emergency department (ED). The cases range from simple viral conjunctivitis to trauma-related eye injuries. One pathological condition that could lead to vision loss is retinal artery occlusion (RAO). Evaluating a patient with an eye symptom requires thorough eye examination and advanced imaging in certain instances. Consultation with an ophthalmologist is also necessary for cases that require treatment recommendations and further testing. In the ED, point-of-care ultrasound (POCUS) is a commonly used diagnostic tool that can be used for ocular examination. CASE REPORT: We reported a case of a 60-year-old man who presented with painless partial right-eye vision loss. POCUS showed decreased flow in the right central retinal artery with an area of the pale retina seen on the image from the retinal camera, suggesting a possible branch RAO. Further examination with POCUS showed plaque formation at the carotid bifurcation, a potential cause of the patient's symptoms. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Emergency physicians and other providers should be encouraged to use POCUS to diagnose eye symptoms accurately and promptly. Abnormal findings will prompt immediate specialty consult and early appropriate management. Our case and other reported cases highlight POCUS's reliability and rapid diagnostic ability.

Recommended Citation

Chirurgi, R., Duvvi, A., Hussain, B., Li, L., Singh, J., Nigussie, A. H., Hashmi, A., Roffe, E., Jauhal, S., Fasazadeh, M., Kalantari, H., & Hassen, G. W. (2024). Monocular Painless Vision Loss in the Emergency Department: Multipurpose Utility of Point-Of-Care Ultrasound. The Journal of Emergency Medicine, 66 (2), 192-196. https://doi.org/10.1016/j.jemermed.2023.10.011