Anatomy of the Eye Quiz

Anatomy of the Eye

• Bony orbit is comprised of seven bones: maxilla, palatine, frontal, sphenoid, zygomatic, ethmoid, lacrimal.
• The orbit houses the globe, orbital fat, extraocular muscles, nerves, blood vessels, and part of the lacrimal apparatus.
• Lacrimal glands produce tears that are secreted through ducts to moisten the cornea and wash debris, draining into the nasolacrimal duct.
• Eyelids contain skin, adnexa (eyelashes), subcutaneous tissue, lymphatics, and muscles.
• Conjunctiva is a transparent membrane; palpebral portion lines eyelids, while bulbar portion covers the globe.
• Extraocular muscles facilitate eye movement; consist of four recti (superior, inferior, medial, lateral) and two oblique muscles (superior, inferior).
• Globe is cushioned in orbit and contains aqueous humor (anterior to lens) and vitreous humor (posterior to lens).

Refractive Apparatus

• Main components affecting vision include cornea, lens, vitreous humor, and aqueous humor.

Perioperative Nursing Considerations

• Ophthalmic patients include premature infants to elderly individuals.
• Patients admitted ambulatory; orientation to surroundings crucial for visually impaired individuals.
• Surgical positioning often requires a supine position; protocols vary by surgeon and institution.
• Collaboration with surgical team ensures patient positioning safety, including use of return electrode pads and safety straps.

Instrumentation and Counting

• Instruments for extra and intraocular surgeries include eye scalpels, scissors, lacrimal probes, and needle drivers.
• Minor count is essential during ophthalmic procedures for instrument safety.

Eye Pharmacology

• Medications for surgical procedures include dilating drops (e.g., phenylephrine, atropine) and constricting drops (e.g., Miochol).
• Viscoelastics lubricate and support tissues during surgery (e.g., sodium hyaluronate).
• Eye irrigation solutions, like Balanced Salt Solution (BSS), maintain cornea moisture.
• Hyperosmotic agents (e.g., mannitol) reduce intraocular pressure.
• Injectable anesthetics are used to manage pain, with lidocaine being common.

Equipment

• Phacoemulsification machines use ultrasound for cataract removal.
• Posterior vitrectomy machines facilitate vitreous removal.
• Cryotherapy machines seal retinal tears.
• Lasers are employed for various ocular interventions including cataract and retinal surgeries.
• Operating microscopes enhance visibility during procedures.

Surgical Interventions

Extraocular Surgeries

• Strabismus surgery corrects ocular misalignment; categories include esotropia, exotropia, hypertropia, and hypotropia.
• Techniques include recession (weakening) and resection (strengthening) procedures.
• Enucleation removes the entire eyeball for severe conditions; an implant supports prosthetics.
• Chalazion removal addresses blockage of meibomian glands; entropion and extropian repairs address eyelid malformations.
• Pterygium excision removes conjunctival growths on the cornea.

Retinal Surgery

• Vitreous humor assists in preserving eyeball shape, but can cause floaters as it ages.
• Increase in floaters may indicate potential retinal detachment.
• Laser treatment for diabetic retinopathy prevents new vessel formation causing vision loss.
• Vitrectomy surgery removes opaque vitreous to enhance vision.
• Pneumatic retinopexy and scleral buckling are techniques to reattach detached retinas.

Intraocular Surgeries

• Cataract surgery involves removing the opaque lens.
• Extra Capsular Cataract Extraction (ECCE) carefully removes the lens while leaving the posterior capsule intact.
• Intra Capsular Cataract Extraction (ICCE) removes the lens within its capsule, typically using a cryoprobe.