Journal of Education and Teaching in Emergency Medicine

Point-of-care ultrasound (POCUS) is used frequently in the emergency department (ED) as a non-invasive diagnostic tool. Ocular POCUS is utilized in patients with vision changes to detect pathologies including retinal detachment, vitreous hemorrhage and central retinal artery occlusion. This case demonstrates the capability of POCUS to detect choroidal hemangiomas, a pathology strongly associated with Sturge-Weber syndrome (SWS). A 31-year-old male with no significant medical history presented with two years of progressive vision changes and headaches. A large right-sided facial birthmark was noted, though the patient had no prior diagnosis. Examination revealed right eye blindness and an afferent pupillary defect. Ocular POCUS revealed retinal detachment and choroidal thickening, which were interpreted as choroidal hemangiomas. Findings were corroborated by MRI. Together with input from our ophthalmology and neurology specialists, a diagnosis of SWS was made. This case demonstrates the utility of POCUS in the rapid identification of choroidal hemangiomas in an adult patient, facilitating an expedited diagnosis of SWS. Because there is no cure for SWS, early diagnosis and management by a multidisciplinary team, including ophthalmology and neurology, is essential to limit the progression of the disease and mitigate its effects.