Eye Conditions and Treatments

Chalazion Removal

• A chalazion is a small (2-8 mm) swelling in the eyelid, caused by inflammation leading to a granuloma.
• Symptoms include a small lump on the eyelid, potential mild pain or irritation, and blurred vision in cases of larger chalazions.

How to Treat Chalazion

• Treatment often involves warm compresses, antibiotic ointments/drops/medication, and cleaning the eyelid.
• Minor procedures, such as chalazion I&D (Incision and Drainage) or chalazion I&C (Incision and Curettage), may be necessary.

Common Instruments Used

• Chalazion Clamp
• Chalazion Curette
• No. 11 Blade
• Jaeger Lid Plate

Retinal Tear

• Symptoms of a retinal tear include blurry vision, flashes or floaters, shadows in peripheral vision, and a gray curtain covering part of the vision.
• A retinal tear can lead to a retinal detachment.

Risk Factors for Retinal Tear

• Advanced age
• High levels of myopia
• Associated lattice degeneration (thin retina patches)
• Trauma
• Family history of retinal tears
• Prior eye surgery

Diagnosing a Retinal Tear

• Patient dilation
• Fundus Photos
• Retinal OCT
• Use of a 90-degree lens at the slit lamp to examine the eye's interior
• Indirect Retinal Exam with a 20D lens

Treating a Retinal Tear

• Photocoagulation: Laser used to seal the retina
• Goal: Prevent fluid from passing through the tear and detaching the retina.

Cryopexy/Cryotherapy

• Extreme cold is employed to seal the retina to the eye's wall.
• Goal: Prevent fluid from flowing through the tear and detaching the retina.

Diabetic Retinopathy

• An eye condition affecting blood vessels in the retina due to diabetes.
• Symptoms include changes in vision (transient), dark floaters/streaks like cobwebs.
• Can lead to other serious eye conditions like macular edema, neovascular glaucoma, and retinal detachment.

Diabetic Retinopathy Treatments

• Injections: Anti-VEGF (vascular endothelial growth factor) to slow or reverse the condition.
• Laser Treatment:
  • Focal Photocoagulation: Seals specific leaking vessels in a small area.
  • Scatter / Pan-retinal Photocoagulation: Slows growth of abnormal vessels over a wider area.

Macular Degeneration

• AMD (Age-Related Macular Degeneration) is the leading cause of vision loss for older adults.
• Affects the central vision.
• Two types:
  • Dry AMD: Slow progression; macula thins with age; no treatment.
  • Wet AMD: Accelerated vision loss; abnormal blood vessel growth in the back of the eye, damaging the macula; treatment available.

Wet AMD Treatment

• Anti-VEGF injections
• Photodynamic Therapy (PDT): combination of injections and laser treatment to seal off abnormal blood vessels.

Dry Eye Treatments

• Punctal Plugs: Tiny devices placed in the tear ducts to obstruct tear drainage, maintaining moisture.

Punctal Plugs (Detail)

• Temporary: Made of collagen, breaks down and is absorbed by the body (lasts days to months).
• Semi-Permanent: Made of silicone or acrylic, removable or can fall out.

How to Insert Punctal Plugs

• Lower puncta drainage (around 70% of tears).
• Use topical anesthetic.
• Punctum gauge for proper plug size.
• Punctum dilator to open the puncta.
• Tools include dilator, inserter, etc.

IPL (Intense Pulsed Light)

• Gentle light pulses treat dry eye (MGD- Meibomian Gland Dysfunction).
• Improves Meibomian gland function by unclogging glands and reducing inflammation.
• Enhances tear film quality/stability by restoring lipid layer of tear film.

Iridotomy

• Used for closed-angle glaucoma or before phakic intraocular lens (PIOL) procedures.
• YAG laser and iridotomy lens used to enlarge the pupil opening in iris (with pilocarpine).

Capsulotomy

• Secondary cataract (posterior capsule opacification).
• Happens months/years after cataract surgery.
• YAG laser procedure for treatment, with pupil dilation.

YAG Laser

• In ophthalmic surgery, particularly with cataract surgery.

Laser Trabeculoplasty

• Treats Open-Angle Glaucoma by lowering IOP.
• Focused laser beam targets the Trabecular Meshwork/Drainage angle of the eye.

Cyclophotocoagulation

• Laser procedure lowering IOP (intraocular pressure) for glaucoma.
• Targets the ciliary processes (eye fluid production).
• Used only on patients with failed trabeculectomy or tube shunts.

Foreign Body (FB) Removal

• Includes anesthetic, needles (18 or 30 gauge), and specialized burrs (e.g., Alger brush) for removal.

Corneal Abrasion

• Causes include poking the eye, foreign objects, dirt/debris, chemicals, rubbing too hard, poor/dirty contacts, infections, high-risk activities without eye protection, and overwearing contacts.
• Symptoms - Pain, worse with closing eye, light sensitivity, tearing/redness, blurred vision.

Corneal Abrasion Treatment

• Inspect for particles, flush with clean water/saline.
• Fluorescein stain to confirm abrasion.
• May use bandage contact lens (BCL).
• Antibiotics or ointments may be prescribed.

Debridement Scaling (Treat MGD)

• Procedure that enhances Meibomian gland function and reduces dry eye symptoms.
• Requires instruments like eye scrapers and cotton-tipped applicators to remove eye crusts.

A quiz covering various eye conditions such as diabetic retinopathy, retinal tears, macular degeneration, and chalazions. Questions cover the diagnosis, treatment options, and disease progression, focusing on appropriate treatment strategies and patient expectations.