Opthalmology

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Aqueous Humor

Fluid normally present in the front and rear chambers of the eye. It is a clear, watery fluid that flows between and nourishes the lens and the cornea; it is secreted by the ciliary processes.

Vitreous Humor

Clear, jelly-like substance that fills the middle eye.

Blepharoplasty

Surgery done on the eyelids - done to correct prosis (sagging eyelids), remove fatty bulges around the eyes, and eliminate hanging skin from the eyelids.

Bridle suture

Suture passed through the superior rectus muscle to rotate the globe downward in eye surgery.

Buckling Component

A peice of silicone sponge, rubber, or semi-hard plastic. Used to fix retinal tears.

Cataract

Clouding of the lens in the eye that affects vision. Mostly related to aging - common in older people.

Chalazion

Tiny cyst of the upper or lower eyelid caused by inflammation of an oil-secreting gland (meibomian gland) in the eyelid.

Choroid

A thin vascular layer between the sclera and the retina. It supplies blood to the retina and conducts arteries and nerves to other structures in the eye. It is pierced from behind by the optic nerve and is firmly adhered to the sclera.

Conformer

Triangular-shaped plastic shell with a central hole and an apex and base. Will keep the shape of your eyelids until you get your prothesis.

Conjunctiva

A thin, clear, moist membrane that coats the inner surfaces of the eyelids and the outer surface of the eye.

Cornea

The clear front window of the eye that transmits and focuses light into the eye.

Cryotherapy

A minimally invasive treatment that uses extreme cold to freeze and destroy diseased tissue, including cancer cells.

Dermatachalasis

Redundant and lax eyelid skin and muscle. Common in the upper eyelids but can be found in the lower eyelid.

Entropion

Mal-position resulting in inversion (inward turning) of the eyelid margin.

Diathermy

The use of heat to destroy abnormal cells.

Ectropion

Abnormal eversion (outward turning) of the lid margin.

Enucleation

Surgical removal of the eye - done to remove a malignant tumor, to relieve intolerable pain in a blind eye, or if the eye has been so extensively damaged that no vision can be retained.

Evisceration

Removal of the viscera - internal material in the eye.

Exoneration

Removal of the eye, adnexa, and part of the bony orbit.

Glaucoma

Is caused by excess pressure of the aqueous humor and the leading cause of blindness.

Globe

Retrobulbar, the eyeball in it's entirety.

Keratoplasty

Corneal transplant.

Keratorefractive procedures

Laser, incisions, thermal, implants, and non-laser lamellar surgery.

Lacrimal Apparatus

The system that forms tears, conveys them through the lacrimal duct to the eye, and drains the tears.

Miotic

Substance that causes constriction of the pupil.

Mydriatic

Substance that enlarges the pupil.

Myopia

Nearsightedness, the ability to see close objects more clearly than distant objects.

Phacoemulsification

A procedure in which the lens (clouded by a cataract) is broken up by ultrasound, irrigated, and then suctioned out.

Pterygium

A winglike triangular membrane - usually associated with the conjunctiva. Happens if you have long exposure to wind.

Ptosis

Drooping or sagging of the eyelid.

Retina

Innermost tunic of the eye: The nerve layer that lines the back of the eye, senses light, and creates impulses that travel through the optic nerve to the brain. This is where the condiditon color blindness comes from. Present in people with not cones in this area.

Sclera

Tough, white outer coat over the eyeball that covers approximately the posterior 5/6's of the eye. Serves to maintain the form of the globe, also known as the outermost tunic of the eye.

Stigmatism

A common form of visual impairment in which part of an image is blurred, due to an irregularity in the curvature of the front surface of the eye (cornea).

Tenometer

Instrument used for measuring tension or pressure, particularly intraocular pressure.

Trabeculectomy

A laser procedure performed only in eyes with open angle glaucoma.

Trigeminal Nerve

5th cranial nerve - the chief nerve of sensation for the face and the motor nerve controlling the muscles for chewing. 3 divisions - ophthalmic, maxillary, and mandibular.

Dacryo-

Combining form referring to the lacrimal apparatus of the eye.

Extrascapular cataract extraction

Small incision - The lens is expressed or removed.

Extrinsic muscles

The 6 muscles of the eye that come from the bones of the orbit and functions of move the eye. The muscles are: Lateral rectus, Inferior rectus, Superior rectus, Inferior oblique, Superior oblique, and Levator palpebrae superioris

Intracapsular cataract extraction

Larger incision - Where the entire capsule is removed.

Iridotomy

Incision of the iris for the creation of a new aperture in iris when the pupil is closed.

Kerato-

Indicating a relation to horny substances or to the cornea.

Lacrimal

Facial bone that along with the Zygomatic bone and palate, helps to form the orbit of the eye.

Limbus cornea

The border of the cornea and the sclera (the white of the eye).
The limbus is a common site for the occurrence of corneal epithelial neoplasm.

Ocutome

A cutting system for a posterior vitrectomy.

Retrobulbar

Behind the eyeball or pons.

Trephine

A cylindrical saw for cutting a circular piece of the cornea.

Tunic

An investing membrane.

What is the purpose of the lacrimal system?

To keep the conjunctiva moist.

What are the 3 tunics of the eye?

Corneoscleral, Uveal, and Retinal.

Corneoscleral tunic

Protective, outermost layer, maintains the boundary of the eye.

Uveal tunic

Middle layer, most complex, provides blood supply and lymphatic drainage.

Retinal tunic

Inner most layer, where images are received.

Pupil

Hole located in the center of the iris of the eye that allows light to enter the retina.

Name the 7 bones that form the orbit.

Frontal, Sphenoid, Ethmoid, Superior Maxillary, Malar (zygotmatic), Lacrimal, and Palate.

The cornea is continuous with the_______.

Sclera.

Name the 2 cavities of the eye.

Anterior and Posterior.

Describe the location and function of the crystalline lens.

The lens is situated behind the pupil, in the fossa patellaris, in front of the vitreous body. It forms the posterior chamber of the eye.

Analyze and describe the "blind spot". Is this normal anatomy?

It's a region of the optic nerve that has NO rods or cones, therefore vision is absent and the brain gets no information from the eye. It is a part of the normal anatomy, you have a blind spot for each eye.

Macula

Central region of the retina.

Fovea Centralis

A small depression that increases visual acuity and contains only cones.

Rods

Important for seeing shades of gray in dim light and for seeing general shapes or outlines.

Cones

Provide color vision in bright light and enable the person to see sharp images.

What fluid if effected and where with Glaucoma?

Aqueous fluid; Anterior chamber.

Why does the increase of IOP lead to blindness?

Because the pressure causes damage to the optic nerve which leads to blindness.

Describe three reasons for cataract formation.

1) age 2) trauma 3) exposure to harmful chemicals..

Describe the formation of a cataract and the symptoms it causes.

The lens clouds, light is unable to pass through as well as it did when the lens was transparent. As it matures, less light is unable to pass, blurring and distorting images.

What happens when a large retinal detachment occurs?

The retina separates from the choroid of the eye. The entire retina will detach = loss of vision.

Explain why a patient may see "spots" or "flashes" of light with the development of renal detachment.

It's caused by the tugging(flashes of light) of the vitreous where it is attached to the retina. As it pus away, fluid becomes condensed and stringy which is seen as spots.

What visual defect will occur in a person who lacks cones in the retina?

color blindness.

What are the four causes of corneal clouding?

1) Eye injuries that leave a dense white scar on the cornea. 2) Severe corneal infection = corneal scarring. 3) Corneal dystrophies. and 4) Inherited diseases of the cornea.

What causes a chalazion?

Caused by an inflammation reaction to material trapped inside an oil-secreting gland in the eyelid.

What causes a pterygium and where is it found?

Prolonged exposure to UV light. Found on the conjunctiva and extends into the cornea.

What condiditon causes dacryocysitis?

Obstruction of the nasolacrimal duct = inflammation of the lacrimal sac.

What is strabismus?

Misalignment or deviation of the eyes that normally work simultaneously to track visual objects. They require about the same vision and accommodative (focusing) ability.

Diplopia

Double vision.

Comitant strabismus

That due to faulty insertion of the eye muscles, resulting in the same amount of deviation regardless of the direction of the gaze

Incomitant strabismus

The amount of misalignment depends upon which direction the eyes are pointed due to weakness of an ocular muscle or muscles.

List 3 indications for enucleation.

1) Malignant neoplasm 2) Penetrating wounds 3) Extensive damage.

Gentamicin

Antibiotic - infection treatment or prevention. Can be administered as ointments - Neomycin and Tobramycin.

Balanced Salt Solution

Isotonic solution - prevents corneal dryness.

Cycolgyl

Cycloplegic - paralyze the ciliary muscles

Tetracaine

Anesthetic - Pain prevention. Ophthaine is also used.

Sodium Hyaluronate

Vitreous substitute - Prevents sclera from collapsing. Expands anterior chamber.

Celestone

Anti-inflammatory - Prevents swelling. Can be a steroid or an NSAID, controls postoperative inflammation. Prednisone and Decadron can also be used.

Epinephrine

Vasoconstrictor

Pilocarpine hydrochloride

Miotic - Pupil-constricting agents that act on the sphincter of the iris. Can be injection or topical.

Atropine

Mydriatic - dilates the pupil for examination of the retina, to prepare the eye for ophthalmoscopy, and to optimize removal of a diseased lens.

Wydase

Enzyme - An additive that disperses anesthetic uniformly.

Surgical repair of the eyelid can be identified as an...

Ptosis (upper eyelid) and entropion (lower eyelid).

Two popular procedures to correct ptosis include...

Levator aponeurosis repair and frontalis suspension.

What type of drape is used to fit they eye?

Adhesive backed aperture drapes.

What's a loupe?

An instrument used by the surgeon that are mounted on a pair of glasses and are used for magnification.

What is the purpose of Weck sponges?

To help suck up fluid/blood in eye surgery.

Why are powder free gloves typically used for eye surgery?

Because the powder from the gloves can create corneal irritation.

What is a caliper used for?

Measuring the incision or open the incision more in preparation of placing a lens.

Recession/resection is used for correcting what condition of the eye?

Strabismus.

What's the common procedure used to treat retinal tears?

Scleral buckle - a silicone bolster that encircles the eye and closes the break by pushing on it.

How is cryotherapy used to treat retinal detachment?

By freezing the break to prevent it progressing to a full-scale detachment.

Why is a gas bubble used during retinal tear surgery?

To create pressure on the retina while subrietnial fluid is reabsorbed and a scar forms.

What kind of gas is used and what does a gas bubble mean to the patient post-op?

C3F8 (perfluoropropane) and SF6 (sulfer hexafluoride). And the patient needs to use proper positioning of the head during their post-op period.

What treatment may be used if buckling or cryosurgery fails?

Vitrectomy- A micro surgical procedure in which specialized micro-instruments and techniques are used to repair retinal disorders.

What procedure is used on infants to open up blocked tear ducts?

Surgical probing - A probe is inserted through the tear duct and saline in injected to ensure an open path.

The topical anesthetic cocaine is often used to prepare the nose, even if general anesthetic is planned. Why?

It provides an added anesthetic effect and vasoconstriction.

What eye excision has better cosmetic results, Enucleation or Evisceration?

Evisceration.

In eye surgery, what procedure is a trephine used for?

Corneal transplantation.

How long can a donor cornea be stored?

Several days.

When might a corneal rejection occur?

Immediately after surgery to as late as 20 years.

Phacoemulsification may be used in Cataract treatments. How does the machine work?

It works with ultrasonic energy to break up the lens.

What can acetylcholine be used for?

Pupil constriction in eye surgery.

What is a diathermy apparatus used to accomplish?

Used to destroy extraocular neoplasms or coagulation by the heating of body tissues with the use of radiation, electric current, and ultrasonic waves.

Measures intraocular pressure (IOP)

Tonometer

Dilating and probing.

Bowman.

Grasping and holding

Bishop-Harmon Iris forceps.

Eye speculum

Barraquer.

Cutting scalpel handle

Beaver.

Micro scissors

Wescott's.

Grasps lower eyelid to facilitate excision

Desmarres chalazion forcepts.

Micro needle holder

Castroviejo needle holder.

Small scissors for blepharoplasty

Stevens tenotomy scissors.

Blunt muscle hook

Jameson muscle hook.

What can be used to replace the vitreous humor?

Sodium hyaluronate.

What is a ocutome used for?

Cuts the vitreous and aspirates it.

What is the purpose of applying fluorescein to the cornea? What tool must be used in conjunction with fluorescein?

It's a diagnostic tool used in diagnosing corneal abrasions, corneal ulcers and herpetic corneal infections.

Which of the 6 extrinsic muscles of the eye rotates the eye away from the mid-line?

Lateral rectus.

Where is the lacrimal gland located?

Located within the upper eyelid near the outer angle of the orbit.

The lacrimal sac narrows into the____________ _______which empties into the_________ ________ of the nose.

nasolacrimal duct; inferior meatus

Uneven curvature of the cornea is known as___________.

Astigmatism.

Ciliary body

An intrinsic muscle consists of unstriped fibers forms a grayish, semitransparent, circular band approximately 1/8in wide on the outer surface of the forward part of the choroid

Iris

the colored portion of the eye, also an intrinsic muscle. Regulates the amount of light entering the eye through the pupil.

Anterior chamber

The space bound anteriorly to the iris and posteriorly to the cornea.

Posterior chamber

The space bound by the lens, ciliary body, and suspensory ligaments.

Refractive media

Includes the cornea, aqueous and vitreous humor, and the lens.

Numerous conditions affect the ophthalmic system. The most common affect is_________.

Trauma.

There are many causes of clouding of the cornea. They include:

Eye injuries that leave a dense white scar on the cornea, severe corneal infection that leads to corneal scarring (keratoconus), corneal dystrophies, inherited disease of the cornea, also cataract or other eye surgery can prompt corneal clouding.

Hyperosmotic drugs

Diuretic, shrink vitreous body, reduces intraocular pressure.

Lubricants

Protect the cornea and replace natural lubrication. Common lubricants: Lacri-lube and Duratears.

Retrobulbar anesthesia

Is given behind the eyeball: Lidocaine, Bupivacaine, Wydase, and Epinephrine.

Dacryocystorhinostomy

Performed to establish a new pathway for tear drainage from the lacrimal sac to the middle meatus of the nose.

A resection done for strabisimus correction has a greater effect on the ________ _________.

lateral rectus.

Hydroxyapatite

ocular implants, are used during Enucleation to provide a base of support for the artificial eye. It's a complex calcium phosphate and a naturally occurring body substance.

Radical Keratomy

Procedure to improve patients with myopia (visual defect in which distant objects appear blurred) to improve vision.

Keratoplasty

Corneal transplant - done to correct a cloudy cornea.

Name an incision that is self-healing.

Corneoscleral or corneal.

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