Ch 26 Ophthalmic Surgery

The number of oblique muscles each eye has:

2 (Superior and inferior)

The number of rectus muscles each eye has:

4 (Superior, inferior, lateral, and medial)

Eye suture sizes:

4-0 to 12-0

The number of muscles that attach the sclera to the bony orbit and move the eyeball around various axes:

6 (allows both eyes to focus on a single point)

Process of focusing:

Accommodation

Recent innovation in strabismus surgery:

Adjustable sutures on the muscles

What lies directly in front of the iris?

Anterior chamber

What two spaces is the anterior cavity divided into?

Anterior chamber and posterior chamber

Performed to remove the vitreous from the anterior chamber:

Anterior vitrectomy

A reassuring environment is particularly important in ophthalmic surgery because:

Anxiety can result in increased hemorrhage and intraocular pressure

The anterior chamber is filled with a liquid called:

Aqueous humor

OU (oculus uterque):

Both eyes

Fluid exits the eye through the ___ and passes into the ___:

Canal of Schlemm; venous system

An inflammatory, benign growth that originates in a sebaceous gland of the eyelid (not infectious, but a granuloma):

Chalazion

Prevent the reflection of light within the eyeball (primary function):

Choroid

An extension of the choroid located at the periphery of the anterior choroid:

Ciliary body

Smooth-muscle tissue to which suspensory ligaments are attached:

Ciliary body

Aqueous humor is produced by the:

Ciliary epithelium

Thin, transparent mucous membrane that lines each eyelid and reflects on the globe and covers the sclera:

Conjunctiva

Clear tissue layer overlying the front of the eyeball:

Cornea

Eye sponge is never to be used on the:

Cornea

Has no blood vessels:

Cornea

Light enters the eye through the ___ and is bent:

Cornea

Light rays are refracted when they pass through the:

Cornea, aqueous humor, lens, and vitreous

Freezing of tissue:

Cryotherapy (scleral buckling) - most common

Inflammation of the lacrimal sac

Dacryocystitis

The creation of a permanent opening in the tear duct for the drainage of tears:

Dacryocystorhinostomy

Mild heat created by a diathermy unit or laser:

Diathermy (scleral buckling)

During Dacryocystorhinostomy, small bone ronguers are needed to:

Enlarge the opening in the lacrimal bone

An abnormal inversion of the lower eyelid:

Entropian

Complete removal of the eyeball (globe):

Enucleation

The 3 tissue layers that compose the cornea:

Epithelium (superficial layer) Stroma Endothelium

Contents of the eye are removed, but the outer shell of the sclera and the muscle attachments are left intact:

Evisceration

Nodal tissue arising from a sebaceous gland is excised from the tarsal plate:

Excision of Chalazion

The prep area includes:

Eyelid and margins, inner and outer canthus, brows, and face, ending usually at the chin

Composed of fibrous connective tissue covered with skin:

Eyelids

Used extensively in the diagnosis and evaluation of retinal and choroid diseases:

Fluorescein angiography

Location where light converges:

Focal point

Causes of cataracts:

Genetic defect, injury, overexposure to ultraviolet light, metabolic disease (diabetes), and age

Group of diseases characterized by optic nerve damage and visual field loss:

Glaucoma

The lids protect the eye from:

Injury and light

Enucleation is performed to treat:

Intraocular malignancy, a penetrating ocular wound, a painful blind eye, or an eye that is blind and painless but disfigured

Pigmented membrane composed mainly of muscle tissue that surrounds the pupil:

Iris

The anterior chamber is divided into two chambers by the:

Iris

The anterior chamber lies in front of the:

Iris

The significance of open sky is:

It exposes the posterior chamber to contamination

Full-thickness transplantation of a donor cornea to restore vision:

Keratoplasty

Tears are produced by the:

Lacrimal gland

Two types of corneal transplantation commonly performed:

Lamellar (partial penetrating) keratoplasty Penetrating (full-thickness) keratoplasty

OS (oculus sinister):

Left eye

Lies directly behind the iris in the anterior chamber:

Lens

The posterior chamber lies in front of the ___ and behind the ___:

Lens; iris

Refraction occurs as:

Light enters the front of the eye and passes through the lens

During cataract surgery, the initial incision is made in the:

Limbus

Eye sponges are made of:

Lint-free cellulose

Used in the evaluation of the orbital and intracranial structures:

Magnetic resonance imaging and computed tomography

During Enucleation, a sphere is placed in the orbital cavity. This is done to:

Maintain the shape of the cavity

Performed to correct deviation of the eye caused by strabismus:

Muscle resection and muscle recession

Commonly used injectable local anesthetics include:

Novocaine 1% to 4% Xylocaine 1% to 2%

Phacoemulsification is the preferred method of cataract removal for most patients because:

Only the target tissue is removed

Used to measure the density of eye tissues and detect abnormalities:

Ophthalmic ultrasonography (2 types of ultrasound, A-scan or B-scan)

Direct examination of the eyes is performed using an:

Ophthalmoscope (magnifies the focal point)

The optic nerve enters the posterior orbital cavity through the:

Optic Foramen

The retina receives and transmits images to the brain via the:

Optic nerve

The sclera communicates with the:

Optic nerve sheath

The term that refers to eyelids:

Palpebral

Conjunctiva is divided into:

Palpebral and bulbar regions

Anterior chamber is not entered, and one half to two thirds of the cornea is transplanted:

Partial penetrating (Lamellar) technique

Anterior chamber is entered, and a full-thickness corneal graft is transplanted:

Penetrating (full-thickness) technique

The fragmentation of tissue by ultrasonic vibration:

Phacoemulsification

Refraction is a test for visual acuity, performed using a:

Phoropter

The standard approved eye prep antiseptic is:

Povidone-iodine 5% (Book) Iodophor (Sheri)

A trephine is used in corneal transplant to:

Produce a button of tissue

This is surgically removed to prevent loss of vision:

Pterygium membrane

Fluid passes from the anterior to posterior chamber through the:

Pupil

Bending of light rays through a transparent medium:

Refraction

In most ophthalmic surgeries, the patient receives a:

Regional anesthetic and monitored sedation is used

The phrase "open sky" refers to a condition resulting from:

Removal of the cornea

Innermost layer of the posterior globe:

Retina

Light that is refracted through the cornea allows images to be focuses on the:

Retina

The photoreceptive layer of the eye:

Retina

OD (oculus dexter):

Right eye

Highly vascular pigmented choroid layer lies directly beneath the:

Sclera

Thich, white, fibrous tissue that encloses about three fourths of the eyeball:

Sclera

Performed when the sensory layer of the retina becomes separated from the pigment epithelial layer:

Scleral buckling

Why is a combination stretcher-operating table used?

Shifting the patient immediately after surgery may result in increased IOP and eye injury

A scleral buckle is a:

Silastic sponge and band encircling the sclera

Used to examine the anterior chamber of the eye:

Slit lamp

During strabismus surgery, this instrument is used to elevate and mobilize the muscle:

Stevens muscle hook

Condition in which the eyes are unable to focus on point because the muscles lack coordination:

Strabismus

Zonules are:

Suspensory ligaments that hold the lens in place (attached to the capsule and ciliary body)

The fibrous connective tissue that compose the eyelids are referred to as the:

Tarsal plate

The purpose of the bridal suture is:

To rotate the globe during surgery

Performed to create a channel from which the aqueous humor may drain form the anterior chamber:

Trabeculectomy (treatment of glaucoma)

The posterior cavity lies at the back of the eyeball and contains a gel called:

Vitreous

Retinal detachment occurs when the retina is torn and is extended by:

Vitreous seeping between the pigment layer and neural layer