What Is the Utility of POCUS for Diagnosing Retinal Detachment?

What Is the Utility of POCUS for Diagnosing Retinal Detachment?
 Authors: Jeffers K, Keim SM, Long B, Gottlieb M, Adhikari SR
 Journal: Journal of Emergency Medicine, July 2026

Conclusions:

  • Emergency clinician-performed ocular POCUS is highly accurate for diagnosing retinal detachment.

  • Across summarized systematic reviews/meta-analyses, POCUS showed high sensitivity and specificity, making it a valuable ED adjunct when fundoscopic exam is limited or ophthalmology is not immediately available.

  • Practical takeaway: in patients with flashes, floaters, curtain-like vision loss, or acute painless visual disturbance, ocular POCUS can rapidly support the diagnosis and expedite ophthalmology involvement.

  • A negative POCUS substantially lowers the likelihood of retinal detachment, but clinical suspicion should still drive ophthalmology follow-up, especially with classic symptoms or poor-quality scans.

Practice Takeaways:

  • Ocular POCUS should be part of the ED toolkit for acute visual symptoms, especially when the fundoscopic exam is limited by small pupils, cataract, patient discomfort, or lack of equipment.

  • Look for a hyperechoic membrane tethered to the optic disc moving independently in the posterior chamber.

  • Be careful not to confuse retinal detachment with posterior vitreous detachment or vitreous hemorrhage; if uncertain, treat the scan as indeterminate and consult ophthalmology.

  • Avoid ocular ultrasound if there is concern for open globe injury.

  • A positive scan should accelerate ophthalmology consultation; a negative scan should not override a concerning history or high-risk exam.

Results:

  • Evidence base included 3 systematic reviews and meta-analyses evaluating POCUS for retinal detachment.

  • Diagnostic performance ranges reported:

    • Sensitivity: 94%–100%

    • Specificity: 83%–100%

    • Positive likelihood ratio: approximately 12–25

    • Negative likelihood ratio: approximately 0.06–0.25

  • These estimates suggest ocular POCUS is useful both for ruling in and substantially lowering suspicion for retinal detachment when performed well.

Methods:

  • Evidence review focused on available systematic reviews/meta-analyses of emergency clinician-performed POCUS for retinal detachment.

  • The review summarized diagnostic test characteristics including sensitivity, specificity, and likelihood ratios.

  • Clinical context: retinal detachment can be difficult to identify on physical exam alone and delayed diagnosis risks permanent vision loss.

Jeffers, K., Keim, S.M., Long, B., Gottlieb, M. and Adhikari, S.R., 2026. What is the utility of point-of-care ultrasound for diagnosing retinal detachment?. The Journal of Emergency Medicine. 

Back to blog