Applications of ocular point-of-care ultrasound assessment in the emergency setting: a scoping review

To evaluate the current body of literature pertaining to the use of ocular point-of-care ultrasound (POCUS) in the emergency department (ED).

A comprehensive literature search was conducted on Scopus, Web of Science, MEDLINE, and Cochrane Central Register of Controlled Trials (CENTRAL) databases. Inclusion criteria were studies written in English and primary clinical studies involving ocular POCUS scans in an ED setting. Exclusion criteria were nonprimary studies (e.g., reviews or case reports), studies written in a non-English language, nonhuman studies, studies performed in a nonemergency setting, studies involving non-POCUS ocular ultrasound modalities, or studies published more than 10 years prior. Data extraction was guided by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) recommendations.

The initial search yielded 391 results with 153 duplicates. Of the remaining 238 studies selected for retrieval and screening, 24 met the inclusion criteria. These 24 included studies encompassed 2,448 patients across prospective, retrospective, cross-sectional, and case series study designs. The majority of included studies focused on the use of POCUS in the ED to measure optic nerve sheath diameter as a proxy for papilledema and metabolic aberrations, while a minority of studies used ocular POCUS to assist in the diagnosis of orbital fractures or posterior segment pathology.

The vast majority of studies investigating the use of ocular POCUS in recent years emphasize its utility in measuring optic nerve sheath diameter and fluctuations in intracranial pressure, though additional outcomes of interest include pathology of the posterior segment, orbit, and globe.