Ophthalmic Pharmacology Quiz
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Questions and Answers

What is the primary function of mydriatic drugs?

  • To inhibit accommodation and focusing
  • To constrict the pupil
  • To dilate the pupil while permitting focus (correct)
  • To provide anesthesia during surgery

    • Which of the following drugs is classified as an anticholinergic that inhibits focusing?

  • Carbachol
  • Atropine (correct)
  • Phenylephrine
  • Pilocarpine

    • What effect does Carbachol have when used in the treatment of glaucoma?

  • It provides analgesia
  • It dilates the pupil
  • It constricts the pupil (correct)
  • It flattens the cornea

    • Which mydriatic drug also serves to facilitate the removal of lenses during surgeries?

    <p>Phenylephrine</p> Signup and view all the answers

    Which of the following drugs is a type of injectable anesthetic used for deeper tissue anesthesia?

    <p>Lidocaine</p> Signup and view all the answers

    What unique property does Tetracaine have when applied directly to the eye?

    <p>It provides loss of corneal sensation</p> Signup and view all the answers

    Why is Epinephrine added to balanced salt solution (BSS) during cataract surgery?

    <p>To maintain pupil dilation</p> Signup and view all the answers

    Which drug is noted for its long duration of action, lasting 7–14 days?

    <p>Atropine</p> Signup and view all the answers

    What is accommodation in the context of vision?

    <p>A process of the lens changing shape for focus</p> Signup and view all the answers

    What condition is characterized by clouding of vision due to opacity in the crystalline lens?

    <p>Cataract</p> Signup and view all the answers

    What does cryotherapy involve in ophthalmic procedures?

    <p>Freezing tissues with a cold probe</p> Signup and view all the answers

    What surgical procedure involves the removal of the eyeball while leaving the surrounding structures intact?

    <p>Enucleation</p> Signup and view all the answers

    What is the phenomenon of refraction in the eye?

    <p>Bending of light rays when passing through the cornea</p> Signup and view all the answers

    What is the primary goal of ophthalmic surgery?

    <p>To restore lost vision</p> Signup and view all the answers

    What is muscle recession in the context of eye surgery?

    <p>Moving the muscle back to relieve tension</p> Signup and view all the answers

    Which of the following describes glaucoma?

    <p>Increased intraocular pressure leading to potential blindness</p> Signup and view all the answers

    What fills the anterior chamber of the eye?

    <p>Aqueous humor</p> Signup and view all the answers

    Which structure is responsible for draining tears from the eye into the nasal sinus?

    <p>Nasolacrimal duct</p> Signup and view all the answers

    What is the role of accommodation in vision?

    <p>To change the shape of the lens for focusing</p> Signup and view all the answers

    Which device is used to measure intraocular pressure (IOP)?

    <p>Tonometer</p> Signup and view all the answers

    What are the components of tears that help prevent infection?

    <p>Proteins, mucus, and enzymes</p> Signup and view all the answers

    What does fluorescein angiography help diagnose?

    <p>Retinal and choroid diseases</p> Signup and view all the answers

    Which part of the eye is located behind the iris and in front of the lens?

    <p>Posterior chamber</p> Signup and view all the answers

    What is the primary function of the eyeglass phoropter during a refraction test?

    <p>To compare different lens combinations</p> Signup and view all the answers

    How does light refraction occur in the eye?

    <p>As light passes through various transparent media</p> Signup and view all the answers

    Which of these statements about tears is incorrect?

    <p>All tears contain the same levels of salts and proteins.</p> Signup and view all the answers

    What is the primary purpose of a slit lamp examination?

    <p>To examine the anterior chamber and surrounding structures</p> Signup and view all the answers

    What factor can increase preoperative anxiety in patients undergoing ophthalmic surgery?

    <p>Being awake during the procedure</p> Signup and view all the answers

    What does the canal of Schlemm do?

    <p>Drains aqueous humor into the venous system</p> Signup and view all the answers

    Which type of ultrasound provides an image showing a series of spots based on tissue density?

    <p>B-scan</p> Signup and view all the answers

    What is the primary function of the choroid layer in the eye?

    <p>To prevent reflection of light within the eyeball</p> Signup and view all the answers

    Which muscle group is responsible for moving the eyeball around different axes?

    <p>Both rectus and oblique muscles</p> Signup and view all the answers

    Which structure is located at the junction of the cornea and sclera?

    <p>Limbus</p> Signup and view all the answers

    What component primarily makes up the eyelids?

    <p>Fibrous connective tissue</p> Signup and view all the answers

    What is the role of the retina in the eye?

    <p>To receive and transmit visual images to the brain</p> Signup and view all the answers

    Which of the following structures is responsible for the shape of the lens during the focusing process?

    <p>Suspensory ligaments</p> Signup and view all the answers

    What type of cells in the retina are responsible for color perception?

    <p>Cones</p> Signup and view all the answers

    What is the term for the space between the upper and lower eyelids?

    <p>Palpebral fissure</p> Signup and view all the answers

    Which layer of the eye is primarily responsible for providing external support to the eyeball?

    <p>Sclera</p> Signup and view all the answers

    Which part of the eye is the primary refractive surface that light first encounters?

    <p>Cornea</p> Signup and view all the answers

    What protects the eye from airborne particles?

    <p>Eyelashes</p> Signup and view all the answers

    Which structure does the optic nerve connect to as it exits the eyeball?

    <p>Optic disc</p> Signup and view all the answers

    What role do sebaceous glands play in eyelid function?

    <p>Secrete waxy oil to seal the eyelids when closed</p> Signup and view all the answers

    What part of the eye is responsible for fine focus and sharp vision?

    <p>Macula</p> Signup and view all the answers

    How can the surgical technologist create a supportive atmosphere for the patient?

    <p>By providing detailed explanations of feelings during the surgery</p> Signup and view all the answers

    Why is verification of the operative site especially important in ophthalmic surgery?

    <p>Marks around the eye may be obscured by drapes</p> Signup and view all the answers

    What steps are involved in verifying an intraocular lens (IOL) before surgery?

    <p>The circulating nurse and the technologist both verify the IOL</p> Signup and view all the answers

    What is the primary position for a patient undergoing ophthalmic surgery?

    <p>Supine with head stabilized</p> Signup and view all the answers

    What potential complication can arise from improper patient transfer after surgery?

    <p>Increased intraocular pressure (IOP)</p> Signup and view all the answers

    What is the standard antiseptic used for eye prep?

    <p>Dilute povidone-iodine</p> Signup and view all the answers

    How should the skin prep for ophthalmic surgery be performed?

    <p>Starting at the eyelid and extending outward</p> Signup and view all the answers

    In which position should the patient’s arms be placed for ophthalmic surgery?

    <p>Tucked at the sides</p> Signup and view all the answers

    What is a primary concern associated with the use of retrobulbar block in ophthalmic procedures?

    <p>It is linked to serious risks in selected patients</p> Signup and view all the answers

    What needs to be prepared before the regional anesthesia is started?

    <p>Prepping supplies for skin prep</p> Signup and view all the answers

    How should excess solution runoff be managed during skin prep?

    <p>By squeezing excess solution from sponges</p> Signup and view all the answers

    What is the role of the surgical technologist during the IOL verification process?

    <p>Verifying the IOL model and lens power</p> Signup and view all the answers

    What factor is critical to keep patients still during eye surgery?

    <p>Ensuring the patient is comfortable</p> Signup and view all the answers

    What might be included in the skin prep of the eye?

    <p>Application of a topical anesthetic</p> Signup and view all the answers

    What is the primary goal of dacryocystorhinostomy surgery?

    <p>To restore drainage into the lacrimal duct system</p> Signup and view all the answers

    Which instruments are typically included in the lacrimal set for dacryocystorhinostomy?

    <p>Silicone tubes and intubation set</p> Signup and view all the answers

    What is commonly used to manage small bleeding vessels during the incision in dacryocystorhinostomy?

    <p>Bipolar electrosurgical unit (ESU)</p> Signup and view all the answers

    During dacryocystorhinostomy, what technique is used to expose the lacrimal sac?

    <p>Osteotomy of the lacrimal bone</p> Signup and view all the answers

    What is the primary function of the handheld battery-powered cautery unit in eye surgery?

    <p>To coagulate very small vessels</p> Signup and view all the answers

    What is the purpose of inserting silicone tubes during dacryocystorhinostomy?

    <p>To facilitate drainage of tears</p> Signup and view all the answers

    What characteristic distinguishes a bipolar electrosurgical unit from a monopolar unit?

    <p>Bipolar units do not require a grounding pad</p> Signup and view all the answers

    Which of the following is a postoperative care instruction for patients after dacryocystorhinostomy?

    <p>Avoid bending over</p> Signup and view all the answers

    What is the purpose of the eye sponge during surgery?

    <p>To absorb blood or fluid</p> Signup and view all the answers

    What type of anesthesia is typically used for muscle resection and recession in strabismus surgery?

    <p>General anesthesia</p> Signup and view all the answers

    Why should sutures be handled gently and minimally during eye surgery?

    <p>To avoid damaging the needle points</p> Signup and view all the answers

    Which dressing provides maximum protection against bumps and abrasions after eye surgery?

    <p>Rigid eye shield</p> Signup and view all the answers

    What happens when traction is applied during strabismus surgery?

    <p>It may induce a vagal response</p> Signup and view all the answers

    What is a critical reason why the surgical technologist must have a steady hand during microsurgery?

    <p>To avoid disturbing the surgical field</p> Signup and view all the answers

    In lateral rectus resection, what is the effect of excising a portion of the muscle?

    <p>It limits the drift of the eye</p> Signup and view all the answers

    What is a recent innovation in strabismus surgery?

    <p>Adjustable sutures on the muscles</p> Signup and view all the answers

    Which component of the microscope is responsible for magnifying the field of view?

    <p>Ocular or eyepiece</p> Signup and view all the answers

    What must be done before moving the operating microscope to avoid damaging it?

    <p>Secure the arms of the microscope</p> Signup and view all the answers

    What is the main purpose of an incision made over the Bowman lacrimal probe?

    <p>To open the lacrimal sac</p> Signup and view all the answers

    What type of sutures are used to secure the lacrimal sac flaps to the nasal mucosa after anastomosis?

    <p>6-0 Vicryl sutures</p> Signup and view all the answers

    What is not a reason for ensuring microscope cords are intact before use?

    <p>To improve magnification quality</p> Signup and view all the answers

    What effect does the surgeon’s need to maintain concentration have on the surgical technologist's actions?

    <p>They should prepare for each step of the procedure</p> Signup and view all the answers

    What is essential to ensure regarding the drugs on the sterile field upon receipt?

    <p>They must be labeled immediately.</p> Signup and view all the answers

    What instrument is primarily used to create an opening in the nasal mucosa during the procedure?

    <p>Tenotomy scissors</p> Signup and view all the answers

    What type of sutures are frequently used to close circumferential incisions in eye surgery?

    <p>Double-arm sutures</p> Signup and view all the answers

    Which of the following local anesthetics is commonly used during ophthalmic procedures?

    <p>Lidocaine hydrochloride 1% to 2%</p> Signup and view all the answers

    What must every drug passed to the surgeon during the procedure do?

    <p>Be identified and acknowledged by the surgeon.</p> Signup and view all the answers

    Which of the following statements about eye sponges is incorrect?

    <p>They are used only on the cornea</p> Signup and view all the answers

    Which gauge of infiltration needles is commonly used in ophthalmic procedures?

    <p>25- to 27-gauge</p> Signup and view all the answers

    Why is it important to test the microscope's adjustments before moving it to the surgical field?

    <p>To accommodate the eyesight of the surgeon and assistant</p> Signup and view all the answers

    What action is advised to prevent the microscope's head from drifting?

    <p>Balance the microscope</p> Signup and view all the answers

    Which of these topical anesthetics is applied over the cornea before injection?

    <p>Proparacaine hydrochloride</p> Signup and view all the answers

    What is a significant risk associated with medication errors during eye surgery?

    <p>Irreparable damage to the eye.</p> Signup and view all the answers

    What should the surgical technologist (ST) ensure about the microsurgical eye instruments before the procedure?

    <p>They are sharp and in good working order.</p> Signup and view all the answers

    What role does the circulator play during the administering of local anesthetics?

    <p>Assisting and providing reassurance.</p> Signup and view all the answers

    What aspect of the surgical procedure does the ST not assess?

    <p>Patient's medical history.</p> Signup and view all the answers

    Why is it crucial to maintain a neat instrument table during ophthalmic procedures?

    <p>To ensure all instruments are accounted for.</p> Signup and view all the answers

    Which of the following is a common type of scissors used in ophthalmic surgery?

    <p>Stevens scissors</p> Signup and view all the answers

    What combination is often used with injectable local anesthetics to enhance their effect?

    <p>Epinephrine</p> Signup and view all the answers

    What is the primary purpose of adding epinephrine to local anesthetics?

    <p>To prolong anesthesia and reduce bleeding</p> Signup and view all the answers

    What should be done with sharp items in the microsurgical instruments?

    <p>They must be maintained smooth and aligned.</p> Signup and view all the answers

    Which local anesthetic is known for its long-acting properties and is often used in combination with lidocaine?

    <p>Bupivacaine</p> Signup and view all the answers

    What is the role of the ST if a patient reports symptoms during surgery?

    <p>They must notify the circulator and surgeon.</p> Signup and view all the answers

    Which additive is contraindicated in cases of skin inflammation or malignancy?

    <p>Hyaluronidase</p> Signup and view all the answers

    What function does sodium hyaluronate serve in ocular procedures?

    <p>Protects endothelium and maintains chamber pressure</p> Signup and view all the answers

    Which of the following agents is classified as an intravenous osmotic diuretic?

    <p>Mannitol</p> Signup and view all the answers

    What is the purpose of using 5-Fluorouracil in ocular surgery?

    <p>To inhibit scar formation</p> Signup and view all the answers

    How is hydroxypropyl methylcellulose generally used in ocular procedures?

    <p>To maintain a deep chamber and protect the corneal epithelium</p> Signup and view all the answers

    What common property do both Polymyxin B/bacitracin and Polymyxin B/neomycin/bacitracin serve?

    <p>They are used for the prophylactic treatment of superficial ocular infections</p> Signup and view all the answers

    Which drug is specifically indicated for treating endophthalmitis?

    <p>Cefazolin</p> Signup and view all the answers

    What is the role of Tissue plasminogen activator (tPA) in ocular treatment?

    <p>To facilitate the lysis of clots</p> Signup and view all the answers

    Which type of anesthetic is not intended for injection, but rather for topical use?

    <p>Cocaine</p> Signup and view all the answers

    What is the primary action of Dexamethasone in ocular treatment?

    <p>Glucocorticoid for inflammation reduction</p> Signup and view all the answers

    What is a key reason for refrigerating products like Viscoat before use?

    <p>Preserve effectiveness</p> Signup and view all the answers

    What condition might necessitate the use of Acetazolamide sodium in ocular procedures?

    <p>Elevated intraocular pressure</p> Signup and view all the answers

    What is the primary role of traction sutures during lateral rectus resection?

    <p>To help position the operative eye</p> Signup and view all the answers

    How is bleeding controlled during the incision of the conjunctiva?

    <p>With cautery</p> Signup and view all the answers

    What should be done after the muscle is incised during the medial rectus recession?

    <p>Elevate the muscle using a muscle hook</p> Signup and view all the answers

    What types of sutures are typically used for reattaching the lateral rectus muscle?

    <p>Nonabsorbable synthetic sutures</p> Signup and view all the answers

    What is a common postoperative complication following muscle procedures in children?

    <p>Postoperative nausea and vomiting</p> Signup and view all the answers

    Which technique allows for transplantation of a full-thickness corneal graft?

    <p>Penetrating keratoplasty</p> Signup and view all the answers

    What is the correct position of the patient during both lateral rectus resection and medial rectus recession?

    <p>Supine with slight elevation of the shoulders</p> Signup and view all the answers

    What is used to measure the distance for the new insertion point of the medial rectus muscle?

    <p>Calipers</p> Signup and view all the answers

    Which instrument is typically part of the corneal transplant set?

    <p>Spatula needle</p> Signup and view all the answers

    How is the conjunctiva closed after muscle procedures?

    <p>With absorbable sutures</p> Signup and view all the answers

    What immediately follows the placement of the empty needle holder and smooth tissue forceps?

    <p>The muscle is elevated away from the globe</p> Signup and view all the answers

    What is the significance of using separate instrument tables during penetrating keratoplasty?

    <p>To prevent cross-contamination</p> Signup and view all the answers

    What additional step is performed if a regional block anesthetic is used prior to surgery?

    <p>Prep the postauricular area</p> Signup and view all the answers

    Which elements are considered common indications for cornea transplantation?

    <p>Infection, degenerative disease, and injury</p> Signup and view all the answers

    What is the primary reason for testing light bulbs before surgery?

    <p>To avoid interruptions due to lighting failure.</p> Signup and view all the answers

    Which technique is essential for moving a microscope safely?

    <p>Handling it with both hands on the vertical column.</p> Signup and view all the answers

    What should be done to the lenses of a microscope to maintain cleanliness?

    <p>Clean them with lens cleaner or water and lens paper.</p> Signup and view all the answers

    What is a common task for an ophthalmic surgical technologist during eye surgery?

    <p>Irrigating the eye periodically to prevent drying.</p> Signup and view all the answers

    When checking microsurgical instruments, what should be inspected for burrs?

    <p>Visually under a microscope or with a lint-free wipe.</p> Signup and view all the answers

    What is the proper incision method for excising a chalazion?

    <p>Vertical incision made through the tarsal plate.</p> Signup and view all the answers

    What is dacryocystorhinostomy primarily performed to treat?

    <p>Obstruction in the tear duct</p> Signup and view all the answers

    What type of anesthesia is generally used before making a chalazion incision?

    <p>Local anesthetic</p> Signup and view all the answers

    What equipment might be necessary in addition to the chalazion set during surgery?

    <p>Bipolar ESU</p> Signup and view all the answers

    How should the scissors be positioned to cut sutures under a microscope?

    <p>Within the scope's field of vision before lowering the tip to the suture.</p> Signup and view all the answers

    What practice should be avoided to maintain the cleanliness of microsurgical instruments?

    <p>Storing instruments uncovered to minimize access.</p> Signup and view all the answers

    What is the best way to prevent the accumulation of dust on the microscope and its attachments?

    <p>Cover them at the end of each day.</p> Signup and view all the answers

    What should an ST do if excessive pressure is applied when using a locking needle holder?

    <p>It can prevent the needle holder from locking.</p> Signup and view all the answers

    What should be used during surgery to keep the eye lubricated?

    <p>BSS</p> Signup and view all the answers

    What is the typical setting for performing chalazion surgery?

    <p>In an outpatient setting or clinician's office.</p> Signup and view all the answers

    What position is the patient placed in for the eye procedure?

    <p>Supine</p> Signup and view all the answers

    Which instrument is used for making an incision in the sclera?

    <p>Westcott scissors</p> Signup and view all the answers

    What is the purpose of applying diathermy during the procedure?

    <p>To create burn marks over the detachment</p> Signup and view all the answers

    What type of suture is primarily used to approximate the sclera?

    <p>4-0 Prolene</p> Signup and view all the answers

    What is the purpose of the buckling components during the surgery?

    <p>To compress the eye inward at the area of detachment</p> Signup and view all the answers

    Which gas is commonly used for intravitreal gas injection?

    <p>Sulfur hexafluoride (SF6)</p> Signup and view all the answers

    What pathological condition is the primary focus of a trabeculectomy?

    <p>Glaucoma</p> Signup and view all the answers

    Which structure is primarily responsible for regulating intraocular pressure?

    <p>Ciliary epithelium</p> Signup and view all the answers

    What is one possible outcome of untreated glaucoma?

    <p>Ischemia of the optic nerve</p> Signup and view all the answers

    What is the method by which the aqueous humor typically exits the eye?

    <p>Via the canal of Schlemm</p> Signup and view all the answers

    What is the purpose of 'polishing the posterior capsule' during surgery?

    <p>To aspirate remaining pieces from the capsule</p> Signup and view all the answers

    What complication may occur if the probe is placed in the center during surgery?

    <p>Anterior vitrectomy is required</p> Signup and view all the answers

    Which materials are commonly used for modern intraocular lenses (IOLs)?

    <p>Silicone and acrylic polymers</p> Signup and view all the answers

    What is the surgical goal of scleral buckling?

    <p>To reattach the sensory retina to the pigment epithelial layer</p> Signup and view all the answers

    What is a common cause of retinal tears leading to detachment?

    <p>Diabetes mellitus and trauma</p> Signup and view all the answers

    Which of the following statements about anterior vitrectomy is correct?

    <p>It removes vitreous from the anterior chamber</p> Signup and view all the answers

    What happens if the posterior capsule ruptures during cataract extraction?

    <p>Prolapse of the vitreous into the anterior chamber may occur</p> Signup and view all the answers

    What is the primary purpose of injecting Healon during surgery?

    <p>To maintain the shape of the anterior chamber</p> Signup and view all the answers

    Which surgical technique involves creating adhesion between retinal layers?

    <p>Cryotherapy and diathermy</p> Signup and view all the answers

    Which suture size is commonly used for closing the conjunctiva after surgery?

    <p>10-0 nylon suture</p> Signup and view all the answers

    What immediate symptom may indicate a retinal tear?

    <p>Sudden loss of vision or shadowing</p> Signup and view all the answers

    During an anterior vitrectomy, why should the primary corneal incision be closed?

    <p>To avoid loss of vitreous</p> Signup and view all the answers

    In what scenario would multifocal optics in IOLs be particularly beneficial?

    <p>To improve both near and distance vision without glasses</p> Signup and view all the answers

    What is the recommended patient care after cataract surgery involving vitrectomy?

    <p>Use of eye drops for several weeks</p> Signup and view all the answers

    What is the purpose of the trephine during the donor cornea preparation?

    <p>To create a tissue button from the donor cornea</p> Signup and view all the answers

    Which technique is typically used to extract the recipient cornea?

    <p>Using vacuum-operated and manually operated trephines</p> Signup and view all the answers

    What type of sutures are used to form the initial landmark sutures in the cornea during graft placement?

    <p>10-0 interrupted nylon sutures</p> Signup and view all the answers

    During fluid replacement in the anterior chamber, what substance is injected if needed?

    <p>Sodium hyaluronate</p> Signup and view all the answers

    What is the primary goal of cataract extraction surgery?

    <p>To restore vision by removing the opaque lens</p> Signup and view all the answers

    What is the first step in the patient prep for cataract surgery?

    <p>Placing the patient in a supine position</p> Signup and view all the answers

    What is indicated when discussing the 'open sky' phase during cornea removal?

    <p>The eye is vulnerable to environmental contamination</p> Signup and view all the answers

    Which instrument is used to create a conjunctival flap?

    <p>Westcott scissors</p> Signup and view all the answers

    What is the most common risk associated with corneal transplantation?

    <p>Rejection of the transplanted tissue</p> Signup and view all the answers

    What is the main advantage of using phacoemulsification for cataract removal?

    <p>It allows safe aspiration of liquefied tissue</p> Signup and view all the answers

    Cataracts are primarily associated with which of the following?

    <p>Age-related changes</p> Signup and view all the answers

    What might be used during capsulorhexis to facilitate the procedure?

    <p>Hydrodissection cannula</p> Signup and view all the answers

    Which suture size is typically used for the scleral support ring?

    <p>6-0 silk sutures</p> Signup and view all the answers

    What kind of incision is made into the anterior chamber during cataract extraction?

    <p>Stab incision</p> Signup and view all the answers

    Study Notes

    Ophthalmic Surgical Procedures

    • Accommodation: A process where the lens changes shape to maintain image focus on the retina.

    • Cataract: Clouding of vision due to opacity in the crystalline lens, its capsule, or both, preventing light focus on the retina.

    • Cryotherapy: Freezing tissue (e.g., sclera, ciliary body) using a cold probe, often after retinal detachment.

    • Diathermy: Low-power cautery used to burn sclera to treat retinal detachment.

    • Enucleation: Surgical removal of the entire eyeball and its attachments.

    • Evisceration: Surgical removal of the eyeball's contents, leaving the sclera intact.

    • Exenteration: Removal of all orbital contents.

    • Focal Point: The point where light rays converge after passing through a lens.

    • Glaucoma: A group of eye diseases with elevated intraocular pressure, potentially causing optic nerve damage and blindness.

    • Keratoplasty: Cornea surgery, including penetrating keratoplasty (corneal transplantation).

    • Muscle Recession: Moving an eye muscle back to release the eyeball.

    • Muscle Resection: Shortening an eye muscle to reposition the eyeball.

    • Phacoemulsification: Using high-frequency sound waves to emulsify tissues, such as a cataract.

    • Pterygium: A triangular membrane arising from the medial canthus, potentially extending over the cornea and causing vision problems.

    • Refraction: Light bending as it passes through a denser medium; occurs in the cornea, lens, aqueous humor, and vitreous.

    • Spatula Needle: A flat-tipped suture needle commonly used in ophthalmic surgery.

    • Strabismus: Inability of extraocular muscles to coordinate, affecting binocular vision.

    Surgical Anatomy

    • Orbital Cavity:  Contains the eyeball (globe), formed by frontal, lacrimal, sphenoid, ethmoid, maxillary, zygomatic, and palatine bones. The optic nerve passes through the optic foramen.

    • Eyelids: Composed of fibrous tarsal plates covered by skin, protecting the eye; the palpebral fissure is the space between the lids, and the canthi are the lid junctions.

    • Globe: Has posterior and anterior cavities (anterior and posterior chambers). The posterior chamber contains vitreous, and anterior chambers contain aqueous humor produced by the ciliary epithelium.

    • Eye Muscles: Six muscles (four rectus, two oblique) move the eyeball, enabling binocular vision.

    • Conjunctiva: Thin, transparent mucous membrane lining the eyelids (palpebral conjunctiva) and extending over the eyeball's visible surface (bulbar conjunctiva).

    • Cornea: Clear tissue layer over the eye's front; refracts light, has no blood vessels.

    • Sclera: Thick, white, fibrous tissue forming the eye's external supporting layer; continuous with the cornea.

    • Choroid: Highly vascular layer beneath sclera, preventing light reflection. Its extension is the ciliary body (smooth muscle controlling lens shape).

    • Iris: Pigmented membrane surrounding pupil controlling light intake.

    • Retina: Photoreceptive layer receiving and transmitting images to the brain via the optic nerve; detects black and white and color. Macula is high-acuity region, and fovea centralis is its center. 

    • Lens: Clear, biconvex disc behind the iris, held by zonules attached to the ciliary body, modifying shape for light focusing.

    • Anterior and Posterior Chambers: The anterior cavity of the eye is divided by the iris; filled with aqueous humor that flows from the posterior chamber through the pupil and to the venous system via the canal of Schlemm.

    • Lacrimal Apparatus: Tears are produced from the lacrimal gland, passing through ducts to the conjunctiva, then draining through punctum, lacrimal sac, and nasolacrimal duct to the nasal cavity.

    Diagnostic Testing

    • Refraction Test: Measures visual acuity using a phoropter with corrective lenses and an eye chart.
    • Slit Lamp Examination: Examines the anterior eye structures (lids, conjunctiva, tear film, cornea, iris, lens, and anterior vitreous). Fluorescein dye is used to highlight corneal irregularities.
    • Tonometry: Measures intraocular pressure (IOP).
    • Ophthalmoscopy: Examines the fundus (rear part) of the eye with a handheld instrument to visualize internal structures. Fluorescein angiography and ophthalmic ultrasonography are also used.

    Case Planning

    • Psychological Considerations: Patients may have fears about blindness and increased anxiety. A calm and supportive environment and clear explanations of the procedures help alleviate these fears.

    • Verification of Operative Site: Particular attention to verifying operative site and implants is essential due to their delicate nature .The American Association of Ophthalmologists provides a protocol for IOL verification with participation from the surgical technologist..

    • Positioning: Patients are positioned supine, often with the head stabilized on a headrest; precautions involved in patient transfer, to avoid increased intraocular pressure.

    Prepping and Draping

    • Skin Prep: Typically performed after anesthesia using dilute povidone-iodine. The prep area includes the eyelids, margins, canthi, eyebrows, and face.
    • Draping: Isolates the hairline and non-operative side of the face using head drapes, fenestrated drapes (for the operative eye), or large body sheets.

    Anesthesia

    • Regional Anesthesia: Mostly used with monitored sedation (topical anesthetic, local infiltration, peribulbar nerve block, or combination).
    • Pediatric Patients: General anesthesia.

    Ophthalmic Drugs

    • Many drugs with potent effects are used pre-, intra-, and post-operatively. All drugs must be clearly labeled; surgeons must acknowledge every drug passed to them, and proper recording of drug amounts is essential.

    Instruments

    • Ophthalmic instruments are delicate and expensive; all personnel must handling carefully to prevent damage.

    Surgical Techniques

    • Microsurgery: Requires focused vision, steady hands, and careful instrument passing to avoid patient harm. Microscope must be positioned and stabilized carefully.

    • Chalazion Excision: A benign growth from a sebaceous gland on the eyelid is excised.

    • Dacryocystorhinostomy: Permanent opening is created in the tear duct for tear drainage.

    • Muscle Resection/Recession: Corrects strabismus (eye misalignment) by detaching and reattaching eye muscles in the correct position.

    • Penetrating Keratoplasty: Transplants a full-thickness donor cornea to replace a damaged cornea.

    • Extracapsular Cataract Extraction (Phacoemulsification): Fragments a cataract in the lens using ultrasonic vibrations to remove the lens, preserving the capsule; an intraocular lens implant replaces the removed lens.

    • Anterior Vitrectomy: Removes vitreous from the anterior chamber, performed in conjunction with other procedures like cataract extraction.

    • Scleral Buckling: Restoring retinal layers in a detached retina by creating adhesions/scar tissue between the layers of the retina, then using a Silastic band to press the retinal layers back against the sclera.

    • Filtering Procedures (Trabeculectomy): Creating a drainage channel for aqueous humor to treat glaucoma.

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    Test your knowledge on the various mydriatic drugs, their functions, and applications in ophthalmology. This quiz covers essential concepts such as drug classifications, treatment effects, and surgical procedures related to eye care. Ideal for students and professionals in the field of optometry and ophthalmology.

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