Emergency Department Use of Ocular Point-of-Care Ultrasound and Its Utility in Diagnosis at a Tertiary Academic Medical Center.
Ocular point-of-care ultrasound minimally impacts ophthalmology referrals.
Emergency Department Use of Ocular Point-of-Care Ultrasound and Its Utility in Diagnosis at a Tertiary Academic Medical Center.
To determine whether the use of ocular point-of-care ultrasound (POCUS) impacts emergency department (ED) need for referral to ophthalmology.
The study included 282 patients who presented at the Vanderbilt University Medical Center (VUMC) ED between January 1, 2021, and October 31, 2024, with an eye-related chief symptom and received both an ocular POCUS and ED or outpatient ophthalmology consultation within 1 week.
There was moderate agreement between the diagnosis made by POCUS and ophthalmology (k = 0.48, P < 0.01).
Point-of-care ultrasound had a high sensitivity for detecting vitreoretinal pathology, such as retinal detachments (sensitivity [sn] = 93.8%, specificity [sp] = 93.8%) and vitreous hemorrhages (sn = 73.0%, sp = 92.8%).
However, the sensitivity for detecting nonvitreoretinal pathology was lower (sn = 13.3%, sp = 99.5%).
There were several vision-threatening conditions that were not diagnosed by POCUS.
Our data show that the results of ocular POCUS had minimal impact on the need for patients to be seen by an ophthalmologist at a tertiary academic center.
Furthermore, although POCUS does have a high sensitivity for detecting retinal detachment and vitreous hemorrhage, it has only moderate accuracy and a low sensitivity for detecting other ocular pathologies that may require prompt intervention, most importantly retinal vascular disease and ischemic optic neuropathy, thereby limiting its use as a diagnostic tool.