Rothko, a 14 year old, male-neutered, 70 lb Shepherd/lab mix, presented on 10/10/18 with exophthalmos of his right eye, he was painful on retropulsion of the right globe and when his mouth was opened. Oral exam was unremarkable. He was afebrile and a CBC was wnl. He was treated with Clindamycin which had no effect. I am new to ocular ultrasonography and would appreciate your help. Is there evidence of a retrobulbar abscess or mass in these clips/stills.
Rothko, a 14 year old, male-neutered, 70 lb Shepherd/lab mix, presented on 10/10/18 with exophthalmos of his right eye, he was painful on retropulsion of the right globe and when his mouth was opened. Oral exam was unremarkable. He was afebrile and a CBC was wnl. He was treated with Clindamycin which had no effect. I am new to ocular ultrasonography and would appreciate your help. Is there evidence of a retrobulbar abscess or mass in these clips/stills. When I compare these images to images of the left eye, it appears to me that there is increased soft tissue density posterior to the globe. Any tips on obtaining better images are appreciated as well.
Thank you for your help.
Comments
I screen shot your first
I screen shot your first video and note the optic nerve (long arrow) and hypoechoic irregular tissue in the retrobulbar space (mid arrows) and the deviation of the globe (small arrow) which looks like a mass effect given the irregular deviation as opposed to a smooth angular change you get with variable positioning. Strong suspicion for mass here usually carcinoma. Needs CT would light this up really well.
Look in the sonopath archive basic search for this CT of a retrobulbar mass… kinda cool:)…not for the patient but it is for imaging nerds:)
https://sonopath.com/members/case-studies/cases/ct-retrobulbar-mass-compression-left-ocular-bulb-9-year-old-m-rottweiler
or just plug in “retrobulbar mass” and get a couple of pages of CT and ultrasound image cases of masses and abscesses behind the eye
https://sonopath.com/members/case-studies/search?text=retrobulbar+mass&species=All
Thank you so much. Very
Thank you so much. Very informative. I will check out the archived cases. I will recommend CT and post results if this is pursued.
excellent we love followup:)
excellent we love followup:)