Scleral Disease

Abstract

As noted in the chapter on normal ultrasound biomicroscopic findings, the sclera can be clearly defined because of its high internal reflectivity compared to surrounding tissues. This allows differentiation between events taking place above or below the sclera and those taking place within the sclera itself. Ultrasound biomicroscopy thus provides a new way of imaging scleral tissue [1] that adds supportive information to the well-established clinical methods of differentiating anterior scleral disease [2,3]. Although the sclera can be imaged by conventional ultrasound, the resolution is not sufficient to clearly differentiate the sclera from surrounding tissue. Conventional ultrasound has been useful in detecting changes in posterior scleritis [4–7], but has limited application in anterior disease. Examination of the sclera can be performed at any point where the moving transducer can be placed directly over the tissue being examined. Exactly how peripheral this is in the individual patient is dependent on anatomical considerations, including the size of the palpebral fissure, the prominence of the globe, and the site of examination (temporal side greater than nasal).