 I'll now demonstrate the immersion technique where we show the front of the eye and can use that. We can use both the standard 10 MHz probe or there are high-frequency probes called UBM or ultrasound biomicroscopy which go from 40 to up to 60 MHz. Now you have a 40 on this machine, I'll demonstrate that, and to do this we have to stand the probe away from the eye because we had that initial signal where information is lost. We have to back off the probe so we can see that part of the eye. So I'll demonstrate that and I will put another drop of anesthetic in our patient's eye here just to make it a little easier on the tissue. There are different kind of little shells you can use with this. There's also a cover you can put over like a bubble cover over the tip and I'll show both of those for you. I use these shells a lot because I get a kind of a better spectrum of the eye but you can also use, as I mentioned, the little bubble cover over the tip. So in this case we just put this little shell between the eyelids, the patient feels a bit of pressure. It usually doesn't hurt at all because we anesthetize the eye and I'll put some water in it. So just look up at the top a little bit. You'll feel this little bit of lip pressure. Doing okay? Mm-hmm. I'll put a little bit of methyl cellulose inside just to kind of seal it so the water doesn't come all streaming out. I'm just going to put some water. It might run down your face a bit but it's just water. We usually use distilled water. Sailing can sometimes get into the probe and cause some problems, especially with the open probe like we use in UBM. So here's an example of the immersion. So we stand it off. We can actually see the structures of the eye without immersion. So here would be, this would be the cornea right here. So your immersion shell's up here, that's full of the fluid. Here's the cornea, here's the anterior chamber, here's the iris, and here's the posterior lens. You can just see all those structures by backing off the probe and allowing us to see them. And you can measure exactly, you can actually use just a major axial length. I would measure from there to there. So from the cornea to the retina to do an axial length measurement. So that's one way to do it. That's a 10-megahertz. So that's going to show you the entire globe. As you go to higher frequencies, then your penetration is less. So you can't really see in the back of the eye, you can see the front up to the, maybe the anterior lens surface. And I'll demonstrate that, this again is a 40-megahertz probe. It goes right into this little shell. You can see the structures demonstrated very nicely. So this would be the cornea here, highly magnified, the iris. Here's the lens, back of the lens. There's a cellar, your body. So you can just see a very, very nice detail of the structures of the eye that way, the anterior segment. So that's an immersion technique. You can always use a little, I use a little bubble to put over the tip and do the same sort of thing. Turn your head towards me. I'll take this out, give you a bath. I'll show one more thing here with the little bubble cover. These, you can buy different kinds of these. This is one brand that I use. It's adapted for this machine, but there's other brands available. And the advantage of these is that you don't have to put that little lid holder, so some patients have trouble with that. So a child or somebody that has tight furnaces or different things, I would probably use this over the immersion shell. I don't get quite the view with this though, so I tend to prefer the shell, but this can be helpful in those cases. So you fill a full of water, and then you just put your probe right into this. You have to get kind of a tight seal, and if you get any bubbles, it can fill up your picture, so you want to really kind of minimize the bubbles. And then you just go right on the eye directly. And you can see the structures, again the same thing. This would be ciliary body, be cornea, be iris, so it's another way to do it using this without having to use the shell. So that's the basic technique that we use, and with that I see a lot of patients with tumors in the eye, we do a lot of melanomas, retinal blastomas, metastatic tumors. Usually with this combination of these things, the A, the B scan, I'm pretty accurate. In fact, one of the big studies done a few years ago called the COM study, COMS, collaborative ocular melanoma study, they found ultrasound was 99.7% accurate in the diagnosis of melanoma. So that's approaching pathology. See a lot of traumatized globes, you know, corneal opacities, dense cataracts, vitreous hemorrhage, we're able to see the internal eye, a lot of orbital problems with muscles, nerves, eye pain, different things, scleritis, inflammatory conditions, tumors. So the whole spectrum of things able to be used with ultrasound. So it's a very helpful modality in the practice of ophthalmology.