Ocular ultrasound being used in an emergency room setting.

Is Ocular Ultrasound the Future of Diagnosing Orbital Cellulitis?

Kai Mendoza in Health & Wellness November 2025 • 4 min read.

"Exploring the potential of bedside ocular ultrasound in emergency medicine for rapid diagnosis and improved patient care."

In the fast-paced environment of emergency medicine, timely and accurate diagnoses are critical. Orbital cellulitis, an infection affecting the tissues around the eye, demands prompt recognition and treatment to prevent severe complications. Traditional diagnostic methods often involve CT scans, which, while effective, can be time-consuming and expose patients to radiation.

Ocular ultrasound has emerged as a promising tool for bedside evaluation, offering a rapid and non-invasive alternative. This technique utilizes high-frequency sound waves to visualize the structures around the eye, enabling clinicians to quickly identify signs of infection and guide further management. The appeal of ocular ultrasound lies in its portability, ease of use, and ability to provide real-time imaging, making it an invaluable asset in the emergency department.

This article explores the utility of ocular ultrasound in diagnosing orbital cellulitis, examining its benefits, limitations, and potential role in improving patient outcomes. We will delve into a specific case study that demonstrates how ocular ultrasound can aid in the initial assessment and decision-making process, highlighting its impact on clinical practice.

The Power of Bedside Ocular Ultrasound: A Case Study

Ocular ultrasound being used in an emergency room setting.

Consider a 36-year-old male presenting to the emergency department with right eye swelling, tearing, and redness following a complicated oral surgery months prior. The patient's symptoms, while concerning, are not definitively indicative of orbital cellulitis. Traditional diagnostic pathways would typically involve a CT scan to confirm the diagnosis.

However, in this case, a bedside ocular ultrasound was performed using a Sonosite MTurbo® 7.5 MHz linear high-frequency probe. The ultrasound revealed edema along the anterior aspect of the orbit with nonspecific thickening of the orbital wall. This finding prompted the medical team to expedite a CT scan with contrast, which subsequently confirmed the diagnosis of orbital cellulitis.

Speed and Efficiency: Ocular ultrasound provided a rapid initial assessment, accelerating the diagnostic process.
Non-Invasive: The procedure is non-invasive, avoiding radiation exposure associated with CT scans.
Real-Time Imaging: Clinicians can visualize the affected area in real-time, aiding in immediate decision-making.

This case underscores the potential of ocular ultrasound as a valuable tool in the initial evaluation of suspected orbital cellulitis. While it may not replace CT scans entirely, it can help prioritize cases, expedite diagnosis, and guide appropriate management strategies.

Future Directions and Research

While the case study and existing research highlight the promise of ocular ultrasound, further studies are needed to fully define its role in diagnosing orbital cellulitis. Future research should focus on evaluating the sensitivity and specificity of ocular ultrasound in a larger patient population, comparing its performance to other diagnostic modalities, and determining its impact on clinical outcomes. Additionally, studies could explore the use of ocular ultrasound in differentiating orbital cellulitis from other conditions with similar symptoms, such as preseptal cellulitis or inflammatory disorders. As technology advances and clinicians gain more experience with ocular ultrasound, its potential as a rapid, non-invasive diagnostic tool in emergency medicine will continue to grow, ultimately leading to improved patient care and outcomes.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.5811/westjem.2014.4.22007, Alternate LINK

Title: Ocular Ultrasound Identifies Early Orbital Cellulitis

Subject: General Medicine

Journal: Western Journal of Emergency Medicine

Publisher: Western Journal of Emergency Medicine

Authors: Tarina Kang, Dina Seif, Mikaela Chilstrom, Tom Malihot

Published: 2014-07-07

Everything You Need To Know

What is ocular ultrasound and how is it useful in diagnosing orbital cellulitis?

Ocular ultrasound is a bedside evaluation technique that uses high-frequency sound waves to visualize the structures around the eye. In the context of orbital cellulitis, it helps clinicians quickly identify signs of infection. The technique’s appeal lies in its portability, ease of use, and ability to provide real-time imaging, making it valuable in emergency settings. While this technique is effective for initial assessments, Computed Tomography (CT) scans are still needed to confirm a diagnosis.

Can you describe the case study example of how ocular ultrasound aided in diagnosing orbital cellulitis?

In the case study, a 36-year-old male presented with right eye swelling, tearing, and redness. A bedside ocular ultrasound, using a Sonosite MTurbo® 7.5 MHz linear high-frequency probe, revealed edema along the anterior aspect of the orbit with nonspecific thickening of the orbital wall. This prompted an expedited CT scan with contrast, which then confirmed the diagnosis of orbital cellulitis. Without the use of the ultrasound, the process would have taken longer.

What are the main advantages of using ocular ultrasound for diagnosing orbital cellulitis in emergency medicine?

Ocular ultrasound offers several advantages in the diagnosis of orbital cellulitis. It provides speed and efficiency, allowing for a rapid initial assessment. It is also non-invasive, avoiding radiation exposure associated with CT scans. Additionally, clinicians can visualize the affected area in real-time, aiding in immediate decision-making. However, it is worth noting that the ultrasound doesn't replace the need for CT scans for final diagnoses.

What further studies and research are needed to better define the role of ocular ultrasound in diagnosing orbital cellulitis?

Future research should focus on evaluating the sensitivity and specificity of ocular ultrasound in larger patient populations and comparing its performance to other diagnostic methods. Further research could determine its impact on clinical outcomes and explore its use in differentiating orbital cellulitis from conditions with similar symptoms, such as preseptal cellulitis or inflammatory disorders. As the technology advances, its potential as a rapid, non-invasive diagnostic tool will continue to grow.

What are the limitations of using ocular ultrasound in diagnosing orbital cellulitis, and how do these limitations affect its role relative to other diagnostic tools like CT scans?

Ocular ultrasound is a valuable initial tool, but it has limitations. It may not replace CT scans entirely, as CT scans provide more detailed imaging and are often necessary to confirm the diagnosis and assess the extent of the infection. Future research aims to clarify the specific role of ocular ultrasound and improve its diagnostic accuracy and ability to differentiate between various orbital conditions. The need for experienced personnel to perform and interpret the ultrasound accurately also presents a limitation.