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A Narrative Review of Point of Care Ultrasound Assessment of the Optic Nerve in Emergency Medicine Lau, Torey; Ahn, Justin S.; Manji, Rahim; Kim, Daniel J.

Abstract

Point of care ultrasound (POCUS) of the optic nerve is easy to learn and has great diagnostic potential. Within emergency medicine, research has primarily focused on its use for the assessment of increased intracranial pressure, but many other applications exist, though the literature is heterogeneous and largely observational. This narrative review describes the principles of POCUS of the optic nerve including anatomy and scanning technique, as well as a summary of its best studied clinical applications of relevance in emergency medicine: increased intracranial pressure, idiopathic intracranial hypertension, optic neuritis, acute mountain sickness, and pediatric intracranial pressure assessment. In many of these applications, sonographic optic nerve sheath diameter (ONSD) has moderately high sensitivity and specificity, but the supporting studies are heterogeneous. Further studies should focus on standardization of the measurement of ONSD, establishment of consistent diagnostic thresholds for elevated intracranial pressure, and automation of ONSD measurement.

Item Metadata

Title
A Narrative Review of Point of Care Ultrasound Assessment of the Optic Nerve in Emergency Medicine
Creator
Lau, Torey; Ahn, Justin S.; Manji, Rahim; Kim, Daniel J.
Contributor
St. Paul's Hospital (Vancouver, B.C.); Vancouver General Hospital
Publisher
Multidisciplinary Digital Publishing Institute
Date Issued
2023-02-15
Description
Point of care ultrasound (POCUS) of the optic nerve is easy to learn and has great diagnostic potential. Within emergency medicine, research has primarily focused on its use for the assessment of increased intracranial pressure, but many other applications exist, though the literature is heterogeneous and largely observational. This narrative review describes the principles of POCUS of the optic nerve including anatomy and scanning technique, as well as a summary of its best studied clinical applications of relevance in emergency medicine: increased intracranial pressure, idiopathic intracranial hypertension, optic neuritis, acute mountain sickness, and pediatric intracranial pressure assessment. In many of these applications, sonographic optic nerve sheath diameter (ONSD) has moderately high sensitivity and specificity, but the supporting studies are heterogeneous. Further studies should focus on standardization of the measurement of ONSD, establishment of consistent diagnostic thresholds for elevated intracranial pressure, and automation of ONSD measurement.
Subject
ultrasound; point of care ultrasound (POCUS); optic nerve; optic nerve sheath diameter (ONSD); intracranial pressure; idiopathic intracranial hypertension; optic neuritis; acute mountain sickness
Genre
Article
Type
Text
Language
eng
Date Available
2025-06-23
Provider
Vancouver : University of British Columbia Library
Rights
CC BY 4.0
DOI
10.14288/1.0449162
URI
http://hdl.handle.net/2429/91397
Affiliation
Medicine, Faculty of; Non UBC; Emergency Medicine, Department of
Citation
Life 13 (2): 531 (2023)
Publisher DOI
10.3390/life13020531
Peer Review Status
Reviewed
Scholarly Level
Faculty; Researcher
Rights URI
https://creativecommons.org/licenses/by/4.0/
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CC BY 4.0