Module 23: Eyes and Laser

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Questions and Answers

How is the energy of a laser beam quantified?

In Volts

In Amperes

In Joules per second

In Watts (correct)

What is the primary characteristic of continuous wave (CW) operation in lasers?

The power output is lower than in pulsed operation

The output is relatively constant over time (correct)

It requires intermittent power sources

The output varies significantly with time

Which class of lasers poses a risk of immediate severe eye damage upon exposure?

Class IV/4

Class II

Class IIIb/3B (correct)

Class III

Which mode of operation allows higher peak powers to be achieved in laser applications?

Pulsed operation Signup and view all the answers

Which of the following laser types is not mentioned as a specific type in the content?

Diode Laser Signup and view all the answers

Which component of the eye is considered the least important in the refractive apparatus?

Aqueous Humour Signup and view all the answers

What is the primary focus of nursing assessment for an ophthalmic patient pre-operatively?

Ensuring the patient is oriented to their physical surroundings Signup and view all the answers

During which stage of surgery is the least amount of instrumentation counted?

Minor Count Signup and view all the answers

Which surgical position is most commonly used for ophthalmology surgeries?

Supine position Signup and view all the answers

What is the main purpose of dilating drops in ophthalmic surgeries?

To dilate pupils for intraocular surgery Signup and view all the answers

In perioperative practice, who is primarily responsible for ensuring safe patient positioning during surgery?

The perioperative nurse Signup and view all the answers

Which instrument is specifically used for intraocular surgery, such as cataract surgical procedures?

Vannas lens scissors Signup and view all the answers

What should be done to accommodate visually impaired patients during pre-operative care?

Provide constant description and reinforcement Signup and view all the answers

What is the primary indication for performing a vitrectomy?

To restore the patient's vision and facilitate treatment of underlying conditions Signup and view all the answers

What technique is used in laser treatment of diabetic retinopathy to prevent blurry vision?

Electrocoagulation of new vessels Signup and view all the answers

What condition might an increase in floaters indicate?

Potential retinal detachment or tearing Signup and view all the answers

Which procedure involves applying pressure against retinal breaks to facilitate reattachment?

Pneumatic retinopexy Signup and view all the answers

What is the main purpose of performing spheral buckling?

To compress the choroid and reattach the retina Signup and view all the answers

In Extra Capsular Cataract Extraction (ECCE), which part of the lens capsule is addressed first?

Anterior capsule Signup and view all the answers

Which statement accurately describes a characteristic of the vitreous fluid with aging?

It decreases in volume and becomes stringy Signup and view all the answers

Which of the following is NOT a method of cataract extraction mentioned?

Capsulorhexis Signup and view all the answers

Which of the following describes a specific risk if the vitreous becomes opaque?

Reduced ability to visualize and treat the retina Signup and view all the answers

What does the acronym LASER specifically refer to?

Light Amplification by Stimulated Emission of Radiation Signup and view all the answers

In the context of laser technology, what does 'coherent' mean?

The laser waves are organized and travel in phase with one another. Signup and view all the answers

What characteristic of laser light allows it to remain concentrated over long distances?

Collimated nature Signup and view all the answers

Which part of the definition of laser refers to creating more photons?

Stimulated Signup and view all the answers

What does monochromatic mean in the context of laser light?

The light has the same color or wavelength throughout. Signup and view all the answers

What is the most defining characteristic that enables lasers to perform precise surgical tasks?

Intensely focused light on tiny areas Signup and view all the answers

What process directly leads to the transmission of laser energy in the form of waves?

Emission of photons Signup and view all the answers

How do laser fibers enhance the effectiveness of laser beams?

By concentrating light onto a tiny spot. Signup and view all the answers

What role does amplification play in the functioning of a laser?

It increases the power and intensity of light. Signup and view all the answers

What happens to photons during the stimulated emission process?

They become excited and generate additional photons. Signup and view all the answers

Which medication is specifically used to inhibit focusing?

Atropine Signup and view all the answers

What is the primary function of viscoelastics during intraocular surgeries?

To lubricate and support tissues Signup and view all the answers

Which of the following agents is used to decrease intraocular pressure during surgery?

Mannitol Signup and view all the answers

What additive is used with local anesthetics to enhance their effect?

Hyaluronidase Signup and view all the answers

Which irrigation solution may have epinephrine added to prevent bleeding during surgery?

Balanced Salt Solution (BSS) Signup and view all the answers

For what purpose are miotic agents typically used in ocular procedures?

To constrict pupils during surgery Signup and view all the answers

What is the primary use of antimetabolites like 5-Fluorouracil in eye surgery?

To inhibit scar formation Signup and view all the answers

Which machine utilizes ultrasound to break up cataracts?

Phacoemulsification machine Signup and view all the answers

Which of the following injectable anesthetics falls within the concentration range for safe use with epinephrine?

Mepivacaine Signup and view all the answers

What is the primary role of balanced salt solution (BSS) in ocular surgery?

To maintain moisture and support Signup and view all the answers

Study Notes

Refractive Apparatus of the Eye

Key components include the cornea, lens, vitreous humour, and aqueous humour.

Perioperative Nursing Considerations

Patients range from premature infants to elderly patients; assessments adapt accordingly.
Ensure patient orientation within the surgical environment, especially for visually impaired patients.
Patient positioning is often supine but varies by surgical procedure and surgeon preferences.
Collaboration with the surgical team is essential for safe positioning and use of devices.
Ensure return electrode pads and safety straps are applied correctly.

Instrumentation and Counting

Utilize specialized instruments during surgeries; examples include:
- Extra capsular instruments for retinal and muscle surgeries.
- Intra capsular micro instruments for cataract surgery.
- Eye scalpel, eye speculum, and various scissors for precise procedures.
Minor surgical count protocols include initial, closing, and final counts.

Eye Pharmacology

Eye drops used for dilation and constriction; examples include:
- Phenylephrine: dilates pupils for surgery.
- Atropine: inhibits focusing.
- Miochol: constricts pupils during anterior surgeries.
Viscoelastics lubricate and support intraocular structures.
Eye irrigation solutions maintain corneal moisture; Balanced Salt Solution (BSS) is commonly used.
Hyperosmotic agents like Mannitol reduce intraocular pressure during surgery.
Local anesthetics (e.g., Lidocaine, Bupivacaine) used with safety considerations regarding concentrations of epinephrine.

Equipment

Phacoemulsification Machine: Uses ultrasound for cataract surgery.
Posterior Vitrectomy Machine: Removes vitreous gel using cutter handpieces; addresses floaters and retinal detachment.

Laser Treatment in Diabetic Retinopathy

Laser energy assists in regressing neovascularization by targeting peripheral retinal tissues.
Early intervention via electrocoagulation prevents blurred vision and potential retinal detachment.
Vitrectomy involves removing opaque vitreous gel to restore vision and treat underlying conditions.

Intraocular Surgeries

Cataract extraction methods include:
- Extra Capsular Cataract Extraction (ECCE): Controlled rupture and removal of the lens.
- Intra Capsular Cataract Extraction (ICCE): Rare procedure involving removal of the lens within its capsule.

Lasers

LASER stands for "Light Amplification by Stimulated Emission of Radiation."
Medical lasers are utilized for precise surgical interventions, focusing on specific tissue areas.

Characteristics of Laser Light

Collimated: Laser energy remains focused over long distances, allowing concentrated application.
Coherent: Waves travel in phase, contributing to beam power.
Monochromatic: Laser light presents a single wavelength, unlike ordinary light.

Laser Power Measurement

Power measured in Watts; energy described in Joules.

Types of Lasers

Common types include CO2 Lasers, Holmium/Yag Lasers, and Green Light KTP Lasers.

Modes of Operation

Continuous Wave (CW): Steady output maintained over time.
Pulsed Operation: Output varies, providing high peak powers for specific applications.

Laser Safety Classes

Class I: Inherently safe (e.g., CD players).
Class II: Safe during normal use (e.g., laser pointers).
Class III: Can cause eye damage; requires caution.
Class IIIb/3B: Severe eye damage risk; requires safety protection.
Class IV/4: High risk of eye/skin damage; strict safety guidelines needed.

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Description

Explore the importance of the refractive apparatus of the eye, including the cornea, lens, vitreous humour, and aqueous humour. This quiz also covers perioperative nursing considerations and assessment for ophthalmic patients across various age groups.