Ocular Auscultation: A Review
DOI:
https://doi.org/10.5195/ijms.2015.125Keywords:
Auscultation, Physical Examination, Carotid Stenosis, Carotid-Cavernous, Sinus Fistula, Neurological ExaminationAbstract
Ocular auscultation is a commonly neglected step of routine physical examination. An adequate ocular auscultation can be helpful in discovering an ocular bruit, which is an important diagnostic finding for a broad spectrum of pathologic conditions, some of which are potentially fatal. In this article, we present a literature review on the physical exam maneuver of ocular auscultation, as well as the pathophysiology and differential diagnosis of ocular bruits. We also included a description of the adequate auscultation technique and a discussion about the applicability of ocular auscultation in clinical practice
Metrics
Metrics Loading ...
References
1. Wadia NH, Monckton G. Intracranial bruits in health and disease. Brain. 1957 Dec;80(4):492-509.
2. Kurtz KJ. Bruits and hums of the head and neck. In: Walker HK, Hall WD, Hurst JW, editors. Clinical methods: the history, physical, and laboratory exa¬minations. 3rd ed. Boston: Butterworths; 1990.
3. Fisher CM. Cranial bruit associated with occlusion of the internal carotid artery. Neurology. 1957 May;7(5):299-306.
4. Jura E, Go?abek R, Kruszewska J, Kryst-Wid?gowska T, Trzebicki J. [Giant ar¬teriovenous angiomas of the brain with scant clinical manifestations]. Neurol Neurochir Pol. 1991 Jan-Feb;25(1):107-13.
5. Smith JH, Fugate JE, Claassen DO. Pearls & oy-sters: the orbital bruit: a poor man’s angiogram. Neurology. 2009 Oct 20;73(16):e81-2.
6. Purcell JJ Jr. The effect of unsuspected carotid-cavernous fistula in enuclea¬tion. Am J Ophthalmol. 1979 Nov;88(5):946-8.
7. Brodsky LP. Auscultation of the human eye as a potential diagnostic aid. J Am Optom Assoc. 1980 Nov;51(11):1031-2.
8. Pessin MS, Panis W, Prager RJ, Millan VG, Scott RM. Auscultation of cervical and ocular bruits in extracranial carotid occlusive disease: a clinical and angiographic study. Stroke. 1983 Mar-Apr;14(2):246-9.
9. Hu HH, Liao KK, Wong WJ, Teng MM, Lo YK, Chu FL, et al. Ocular bruits in ischemic cerebrovascular disease. Stroke. 1988 Oct;19(10):1229-33.
10. Nisbet RM, Barber JC, Steinkuller PG. Doppler ultrasonic flow detector: an adjunct in evaluation of orbital lesions. J Pediatr Ophthalmol Strabismus. 1980 Jul-Aug;17(4):268-71.
11. Stokke TM, Ruddox V, Sarvari SI, Otterstad JE, Aune E, Edvardsen T. Brief group training of medical students in focused cardiac ultrasound may im¬prove diagnostic accuracy of physical examination. J Am Soc Echocardiogr. 2014 Nov;27(11):1238-46.
12. Biousse V, Mendicino ME, Simon DJ, Newman NJ. The ophthalmology of intracranial vascular abnormalities. Am J Ophthalmol. 1998 Apr;125(4):527-44.
13. Poppen JL. Cranial bruit; its significance. Surg Clin North Am. 1955 Jun;Lahey Clinic No.:881-6.
14. Tiefert JW. Orbital auscultation. Am Fam Physician. 1978 Dec;18(6):117-20.
15. Ellis JA, Goldstein H, Connolly ES Jr, Meyers PM. Carotid-cavernous fistu¬las. Neurosurg Focus. 2012 May;32(5):E9.
16. Kato M, Ikegame Y, Toyoda I, Ogura S, Kitajima H, Yoshimura S, et al. He¬mispheric
laminar necrosis as a complication of traumatic carotid-cavernous sinus fistula. Neurol Med Chir (Tokyo). 2009 Jan;49(1):26-9.
17. Ali S, Khan MA, Khealani B. Limb-shaking transient ischemic attacks: case report and review of literature. BMC Neurol. 2006;6:5.
18. Hirose Y, Yanagi T, Ito Y, Yasuda T. [Clinical significance of carotid and ocular bruits in cerebrovascular disease]. Rinsho Shinkeigaku. 1992 Oct;32(10):1081-6.
19. Gautier JC, Rosa A, Lhermitte F. [Carotid auscultation. Correlation in 200 patients with 332 angiograms]. Rev Neurol (Paris). 1975 Mar;131(3):175-84.
20. Ebihara A, Ashida T, Sugiyama T, Okuno S, Fujii J, Yonemitsu T. [An elderly hypertensive patient with ocular bruits and angiographically confirmed ste¬nosis of intracranical internal carotid arteries]. Nihon Ronen Igakkai Zasshi. 2002 Jan;39(1):94-6.
21. Lauritzen M, Alving J, Paulson OB. Orbital bruits and retinal artery pressu¬re in internal carotid artery occlusion. Clin Neurol Neurosurg. 1981;83(1):7-10.
22. Countee RW, Gnanadev A, Chavis P. Dilated episcleral arteries--a signifi¬cant physical finding in assessment of patients with cerebrovascular insuffi¬ciency. Stroke. 1978 Jan-Feb;9(1):42-5.
23. Gilbert GJ. Physical diagnosis of temporal arteritis. Eye Ear Nose Throat Mon. 1971 Dec;50(12):476-8.
24. Gilbert GJ. Eyeball bruits in temporal arteritis. Dis Nerv Syst. 1970 Feb;31(2):130-2.
25. Jazayeri F, Pearson A. Orbital bruit in Churg-Strauss orbitopathy; a novel sign. Orbit. 2012 Apr;31(2):65-6.
26. Wales RT, Martin EA. Arterial bruits in anemia. Br Med J. 1963 Dec 7;2(5370):1444-7.
27. Parry DH, Worwood M, Jacobs A. Letter: Increased serum iron in acute leukaemia. Br Med J. 1975 Aug 9;3(5979):372.
28. Nugent JS, O’Brien KE, Harris M, Mohan C. Paget’s disease of bone in an Indian patient: genetic and environmental factors. J Clin Rheumatol. 2002 Aug;8(4):212-6.
29. National Institute of Health. A classification and outline of cerebrovascu¬lar diseases. II. Stroke. 1975 Sep-Oct;6(5):564-616.
30. Atta HR, Dick AD, Hamed LM, Byrne SF, Gendron EK, Hughes RL, et al. Venous stasis orbitopathy: a clinical and echographic study. Br J Ophthalmol. 1996 Feb;80(2):129-34.
2. Kurtz KJ. Bruits and hums of the head and neck. In: Walker HK, Hall WD, Hurst JW, editors. Clinical methods: the history, physical, and laboratory exa¬minations. 3rd ed. Boston: Butterworths; 1990.
3. Fisher CM. Cranial bruit associated with occlusion of the internal carotid artery. Neurology. 1957 May;7(5):299-306.
4. Jura E, Go?abek R, Kruszewska J, Kryst-Wid?gowska T, Trzebicki J. [Giant ar¬teriovenous angiomas of the brain with scant clinical manifestations]. Neurol Neurochir Pol. 1991 Jan-Feb;25(1):107-13.
5. Smith JH, Fugate JE, Claassen DO. Pearls & oy-sters: the orbital bruit: a poor man’s angiogram. Neurology. 2009 Oct 20;73(16):e81-2.
6. Purcell JJ Jr. The effect of unsuspected carotid-cavernous fistula in enuclea¬tion. Am J Ophthalmol. 1979 Nov;88(5):946-8.
7. Brodsky LP. Auscultation of the human eye as a potential diagnostic aid. J Am Optom Assoc. 1980 Nov;51(11):1031-2.
8. Pessin MS, Panis W, Prager RJ, Millan VG, Scott RM. Auscultation of cervical and ocular bruits in extracranial carotid occlusive disease: a clinical and angiographic study. Stroke. 1983 Mar-Apr;14(2):246-9.
9. Hu HH, Liao KK, Wong WJ, Teng MM, Lo YK, Chu FL, et al. Ocular bruits in ischemic cerebrovascular disease. Stroke. 1988 Oct;19(10):1229-33.
10. Nisbet RM, Barber JC, Steinkuller PG. Doppler ultrasonic flow detector: an adjunct in evaluation of orbital lesions. J Pediatr Ophthalmol Strabismus. 1980 Jul-Aug;17(4):268-71.
11. Stokke TM, Ruddox V, Sarvari SI, Otterstad JE, Aune E, Edvardsen T. Brief group training of medical students in focused cardiac ultrasound may im¬prove diagnostic accuracy of physical examination. J Am Soc Echocardiogr. 2014 Nov;27(11):1238-46.
12. Biousse V, Mendicino ME, Simon DJ, Newman NJ. The ophthalmology of intracranial vascular abnormalities. Am J Ophthalmol. 1998 Apr;125(4):527-44.
13. Poppen JL. Cranial bruit; its significance. Surg Clin North Am. 1955 Jun;Lahey Clinic No.:881-6.
14. Tiefert JW. Orbital auscultation. Am Fam Physician. 1978 Dec;18(6):117-20.
15. Ellis JA, Goldstein H, Connolly ES Jr, Meyers PM. Carotid-cavernous fistu¬las. Neurosurg Focus. 2012 May;32(5):E9.
16. Kato M, Ikegame Y, Toyoda I, Ogura S, Kitajima H, Yoshimura S, et al. He¬mispheric
laminar necrosis as a complication of traumatic carotid-cavernous sinus fistula. Neurol Med Chir (Tokyo). 2009 Jan;49(1):26-9.
17. Ali S, Khan MA, Khealani B. Limb-shaking transient ischemic attacks: case report and review of literature. BMC Neurol. 2006;6:5.
18. Hirose Y, Yanagi T, Ito Y, Yasuda T. [Clinical significance of carotid and ocular bruits in cerebrovascular disease]. Rinsho Shinkeigaku. 1992 Oct;32(10):1081-6.
19. Gautier JC, Rosa A, Lhermitte F. [Carotid auscultation. Correlation in 200 patients with 332 angiograms]. Rev Neurol (Paris). 1975 Mar;131(3):175-84.
20. Ebihara A, Ashida T, Sugiyama T, Okuno S, Fujii J, Yonemitsu T. [An elderly hypertensive patient with ocular bruits and angiographically confirmed ste¬nosis of intracranical internal carotid arteries]. Nihon Ronen Igakkai Zasshi. 2002 Jan;39(1):94-6.
21. Lauritzen M, Alving J, Paulson OB. Orbital bruits and retinal artery pressu¬re in internal carotid artery occlusion. Clin Neurol Neurosurg. 1981;83(1):7-10.
22. Countee RW, Gnanadev A, Chavis P. Dilated episcleral arteries--a signifi¬cant physical finding in assessment of patients with cerebrovascular insuffi¬ciency. Stroke. 1978 Jan-Feb;9(1):42-5.
23. Gilbert GJ. Physical diagnosis of temporal arteritis. Eye Ear Nose Throat Mon. 1971 Dec;50(12):476-8.
24. Gilbert GJ. Eyeball bruits in temporal arteritis. Dis Nerv Syst. 1970 Feb;31(2):130-2.
25. Jazayeri F, Pearson A. Orbital bruit in Churg-Strauss orbitopathy; a novel sign. Orbit. 2012 Apr;31(2):65-6.
26. Wales RT, Martin EA. Arterial bruits in anemia. Br Med J. 1963 Dec 7;2(5370):1444-7.
27. Parry DH, Worwood M, Jacobs A. Letter: Increased serum iron in acute leukaemia. Br Med J. 1975 Aug 9;3(5979):372.
28. Nugent JS, O’Brien KE, Harris M, Mohan C. Paget’s disease of bone in an Indian patient: genetic and environmental factors. J Clin Rheumatol. 2002 Aug;8(4):212-6.
29. National Institute of Health. A classification and outline of cerebrovascu¬lar diseases. II. Stroke. 1975 Sep-Oct;6(5):564-616.
30. Atta HR, Dick AD, Hamed LM, Byrne SF, Gendron EK, Hughes RL, et al. Venous stasis orbitopathy: a clinical and echographic study. Br J Ophthalmol. 1996 Feb;80(2):129-34.
Published
2015-04-05
How to Cite
Fernando Gallego, D., Rivas-Grajales, A. M., & Jose Gallego, C. (2015). Ocular Auscultation: A Review. International Journal of Medical Students, 3(2), 102–106. https://doi.org/10.5195/ijms.2015.125
License
Authors who publish with this journal agree to the following terms:
- The Author retains copyright in the Work, where the term “Work” shall include all digital objects that may result in subsequent electronic publication or distribution.
- Upon acceptance of the Work, the author shall grant to the Publisher the right of first publication of the Work.
- The Author shall grant to the Publisher and its agents the nonexclusive perpetual right and license to publish, archive, and make accessible the Work in whole or in part in all forms of media now or hereafter known under a Creative Commons Attribution 4.0 International License or its equivalent, which, for the avoidance of doubt, allows others to copy, distribute, and transmit the Work under the following conditions:
- Attribution—other users must attribute the Work in the manner specified by the author as indicated on the journal Web site; with the understanding that the above condition can be waived with permission from the Author and that where the Work or any of its elements is in the public domain under applicable law, that status is in no way affected by the license.
- The Author is able to enter into separate, additional contractual arrangements for the nonexclusive distribution of the journal's published version of the Work (e.g., post it to an institutional repository or publish it in a book), as long as there is provided in the document an acknowledgment of its initial publication in this journal.
- Authors are permitted and encouraged to post online a prepublication manuscript (but not the Publisher’s final formatted PDF version of the Work) in institutional repositories or on their Websites prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work. Any such posting made before acceptance and publication of the Work shall be updated upon publication to include a reference to the Publisher-assigned DOI (Digital Object Identifier) and a link to the online abstract for the final published Work in the Journal.
- Upon Publisher’s request, the Author agrees to furnish promptly to Publisher, at the Author’s own expense, written evidence of the permissions, licenses, and consents for use of third-party material included within the Work, except as determined by Publisher to be covered by the principles of Fair Use.
- The Author represents and warrants that:
- the Work is the Author’s original work;
- the Author has not transferred, and will not transfer, exclusive rights in the Work to any third party;
- the Work is not pending review or under consideration by another publisher;
- the Work has not previously been published;
- the Work contains no misrepresentation or infringement of the Work or property of other authors or third parties; and
- the Work contains no libel, invasion of privacy, or other unlawful matter.
- The Author agrees to indemnify and hold Publisher harmless from the Author’s breach of the representations and warranties contained in Paragraph 6 above, as well as any claim or proceeding relating to Publisher’s use and publication of any content contained in the Work, including third-party content.
Enforcement of copyright
The IJMS takes the protection of copyright very seriously.
If the IJMS discovers that you have used its copyright materials in contravention of the license above, the IJMS may bring legal proceedings against you seeking reparation and an injunction to stop you using those materials. You could also be ordered to pay legal costs.
If you become aware of any use of the IJMS' copyright materials that contravenes or may contravene the license above, please report this by email to contact@ijms.org
Infringing material
If you become aware of any material on the website that you believe infringes your or any other person's copyright, please report this by email to contact@ijms.org
