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In this retrospective study on optic nerve sheath diameter (ONSD), the sagittal measurement was statistically disparate from the transverse measurement, with the authors recommending the transverse approach.
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Optic Nerve Sheath Diameter: Which Axis Should Be Measured? J Neuroimaging. 2025 Jul-Aug;35(4):e70076. doi: 10.1111/jon.70076. PMID: 40754891; PMCID: PMC12319288.
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Ocular ultrasound on healthy volunteers found a small decrease in optic nerve sheath diameter (ONSD) in females vs males and in the sitting position vs. supine.
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The impact of demographics and positioning on the imaging features of the optic nerve sheath and ophthalmic vessels. Ultrasound J. 2025 Jan 16;17(1):6. doi: 10.1186/s13089-025-00403-x. PMID: 39821587
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Subconjunctival hemorrhage (SCH) is not more common in infants and toddlers with Valsalva-associated problems like cough, vomiting, or constipation, and clinicians should avoid attributing SCH in infants and toddlers to these causes.
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Subconjunctival Hemorrhages Are Rare Among Infants With Cough and Gastrointestinal Conditions. Pediatr Emerg Care. 2024 Oct 30. doi: 10.1097/PEC.0000000000003293. Epub ahead of print. PMID: 39475329
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There are no symptoms that reliably predict the presence of bacteria in children with conjunctivitis. Most kids with conjunctivitis get better with or without antibiotics, even if bacteria are present.
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Etiology and Outcomes of Acute Infectious Conjunctivitis in Children. J Pediatr. 2024 Oct 18;276:114368. doi: 10.1016/j.jpeds.2024.114368. Epub ahead of print. PMID: 39428088
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Clinical practice guidelines that emphasize the use of narrow-spectrum antibiotics for preseptal cellulitis can be useful in decreasing use of broad-spectrum antibiotics, particularly those targeted at MRSA.
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Improving Antibiotic Use in Pediatric Preseptal Cellulitis Using a Clinical Practice Guideline. Hosp Pediatr. 2024 Oct 1;14(10):791-798. doi: 10.1542/hpeds.2023-007581. PMID: 39246158
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The ACEP consensus seems to indicate that it may be safe for patients with a simple corneal abrasion to go home with 24 hour usage of topical anesthetics for pain relief, but the ophthalmologists are not on board.
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This retrospective study showed that EM providers are equipped to perform lateral canthotomy and cantholysis (C&C) in cases of orbital compartment syndrome (OCS) with success rates comparable to ophthalmologists.
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Success rates of lateral canthotomy and cantholysis for treatment of orbital compartment syndrome. Am J Emerg Med. 2023 Jun 1;70:140-143. doi: 10.1016/j.ajem.2023.05.037. Epub ahead of print.
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Orbital cellulitis is a high-risk and low-prevalence disease characterized by a painful, red eye, usually with eyelid erythema. Red flags include pain with eye movements, photophobia, diplopia, decreased visual acuity, decreased color vision, and proptosis.
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High risk and low prevalence diseases: Orbital cellulitis. Am J Emerg Med. 2023 Jun;68:1-9. doi: 10.1016/j.ajem.2023.02.024. Epub 2023 Feb 26.
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A smartphone app was developed to provide cobalt blue lighting in selfie mode to diagnose corneal injuries. See images below!
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Using Tegaderm™ during ocular ultrasound was associated with poorer image quality and had no effect on patient comfort. If you’re using ocular ultrasound as a modality, consider if using a Tegaderm™ will get in the way of a good diagnosis.
Source
Covered or uncovered: A randomized control trial of Tegaderm versus no Tegaderm for ocular ultrasound. Am J Emerg Med. 2022 Aug 28;61:87-89. doi: 10.1016/j.ajem.2022.08.044. Online ahead of print.