Ocular Auscultation: A Review
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
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, Gołabek R, Kruszewska J, Kryst-Widźgowska 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.
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