B-scan ultrasonography is commonly employed for the diagnosis and follow-up of ocular trauma. This retrospective study looked at the accuracy and predictive ability of B-scan ultrasonography following open globe repair. Of the 965 patients identified with open globe injuries at the Massachusetts Eye and Ear Infirmary, 210 patients were considered suitable for B-scan ultrasonography. The time of scan ranged from day one to five years with a median of nine days after the repair. Mean patient age was 43 years with 73% of the patients been male. The team analysed 427 scans with the main outcome measure as the final visual acuity. The scan analysis revealed 59 serous choroidal detachments, 57 retinal detachments, 47 haemorrhagic choroidal detachments, 19 retinal tears, 18 vitreous traction and 10 kissing choroidal detachments. The ultrasound had a 100% positive predictive value for diagnosing retinal detachment and intraocular foreign body. The authors conclude B-scans are cost-effective and reliable for assessing open globe injuries.