Introduction – To Pack or Not to Pack?

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Nurses Edition Commentary

Mizuho Morrison, DO, Lisa Chavez, RN, and Kathy Garvin, RN
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Douglas Y. -

I have used ocular ULS a few times and have picked up some detachments and hemorrhages and it is no doubt more sensitive for retinal detachment than direct fundoscopy. However in discussion with the retinal specialist that I have seen (for my own eye issues ), ULS will miss retinal tears. This would be the time to catch them before they detach. So I I think any new onset flashers still will need urgent consultor f/u with ophthalmology regardless of ULS findings

Michael L. -

Using US for retinal tears for ~ 13 years. The emergent component is sorting out which retinal tears have macula "on or off". True ocular emergencies have macula still attached just lateral to the optic nerve. Call to Ophthalmologist immediately to repair before macula detaches and fine detailed vision lost ( macula-many cones, few rods). When the macula is not spared, it is more of an urgency and can be seen in the next few days. Gladly send diagrams and images that reveal ->Retinal detachment (RD) with and without macula sparing. Typical RD shows prominent, continuous linear density ( hyperechoic) rising from the fundus. Depending on the severity of the RD...visible as a thin hyperechoic peripheral convexity or bright squiggle lines. In all but traumatic penetrating injuries, the retina remains tethered to the Ora serrata and the Optic nerve.

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