Ultrasound biomicroscopical diagnosis of traumatic choroidal effusion without cyclodialysis

Background. Chamber angle changes due to trauma represent a diagnostic chal lenge in modern ophthalmology and two examination techniques are compared: gonioscopy which has been used in ophthalmology for almost a century and is still undergoing continuous improvements and ultrasound biomicroscopy (UBM ) which was introduced into clinical ophthalmology in 1991. Case report. We report the case of a 14-year-old boy with ocular trauma cau sed by a soft gun projectile. Gonioscopy showed a large goniosynechia in th e presence of ocular hypotension,therefore, cyclodialysis was suspected. Ho wever, a control investigation using UBM showed an intact and circularly at tached but anteverted ciliary body behind the synechia, a circular choroida l effusion and an anterior displacement of the iris-lens diaphragm. Conclusion. In ocular trauma, UBM may under certain conditions clearly be o f a higher diagnostic value than gonioscopy. Therefore, UBM should not only be considered as an additional examination technique in the evaluation of traumatic ocular pathologies but rather as the technique of choice.