Ophthalmology and Laser Surgery Module 23

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Questions and Answers

What is the primary function of the lacrimal apparatus in the eye?

Facilitating ocular movements through muscle contraction

Providing structural support to the eyeball

Transmitting visual signals to the brain

Producing and secreting tears to maintain corneal moisture (correct)

Which of the following bones is NOT part of the bony orbit?

Humerus (correct)

Zygomatic bone

Frontal bone

Maxilla

Which extrinsic eye muscle is responsible for moving the eye upward?

Medial rectus

Superior rectus (correct)

Inferior oblique

Lateral rectus

What structure is primarily responsible for draining tears from the eye?

Lacrimal sac Signup and view all the answers

What type of surgery involves accessing structures inside the eyeball?

Intraocular surgery Signup and view all the answers

Which of the following components is NOT included in the anatomy of the eyeball?

Choroid layer Signup and view all the answers

What is the role of the extraocular muscles?

Facilitating movement of the eyeball Signup and view all the answers

Which portion of the conjunctiva lines the surface of the globe?

Bulbar conjunctiva Signup and view all the answers

What is the primary duty of the second circulating registered nurse during a laser procedure?

Attend to other requirements throughout the procedure Signup and view all the answers

Which of the following requirements is NOT necessary for the use of laser eye protection?

Padded frames for comfort during extended use Signup and view all the answers

When should the laser-specific warning signs be removed?

When the laser treatment is completed Signup and view all the answers

What action should be taken if there is a breach in laser safety protocol?

Document the breach and inform the laser safety officer Signup and view all the answers

What is one method to minimize risks associated with reflections in the laser area?

Reduce reflective surfaces in the controlled area Signup and view all the answers

What is the primary purpose of using a cryotherapy machine in ophthalmic procedures?

To create an inflammatory reaction that seals breaks in the retinal tissue Signup and view all the answers

Which of the following correctly differentiates between strabismus categories?

Esotropia is characterized by inward turning, while hypertropia involves one eye being higher. Signup and view all the answers

What surgical approach is taken during the recession method of strabismus repair?

Attaching the muscle at a point further back from the front of the eye Signup and view all the answers

Which procedure is indicated for a painful, blind eye due to trauma or intraocular tumors?

Enucleation Signup and view all the answers

Which of the following correctly describes entropion and extropian surgical repairs?

Entropion involves the repair of the inverted eyelid, while extropian addresses the eversion of the lower lid. Signup and view all the answers

What is the purpose of using lasers in ophthalmic surgeries?

To reshape or create a flap of the cornea and clear opacified areas Signup and view all the answers

In the context of enucleation, what role does the round implant play?

It provides support for a prosthetic eye. Signup and view all the answers

What type of fluid fills the majority of the eye and assists in maintaining its shape?

Vitreous fluid Signup and view all the answers

Which condition is characterized by a fleshy, triangular encroachment of conjunctiva onto the peripheral cornea?

Pterygium Signup and view all the answers

What is the expected outcome of surgical intervention for strabismus in pediatric patients?

Correction of ocular misalignment and improved eye coordination Signup and view all the answers

What is indicated if patients experience an increase in floaters?

Possible retinal detachment or tears Signup and view all the answers

Which procedure uses laser treatment to manage neovascularization in diabetic retinopathy?

Laser photocoagulation Signup and view all the answers

What is the primary goal of vitrectomy surgery?

To restore patient vision and treat underlying conditions Signup and view all the answers

What technique is used during pneumatic retinopexy?

Injection of a bubble of air or gas into the vitreous body Signup and view all the answers

Which surgical method is characterized by the removal of the lens with its capsule using a cryoprobe?

Intracapsular cataract extraction (ICCE) Signup and view all the answers

What is a common consequence of bleeding from newly formed vessels in the vitreous gel?

Opacity in the vitreous and decreased vision Signup and view all the answers

What is the mechanism of action for scleral buckling?

Using silicone to push the retina into anatomical position Signup and view all the answers

Which type of cataract surgery involves the removal of the anterior portion of the capsule in a controlled manner?

Extracapsular cataract extraction (ECCE) Signup and view all the answers

What condition could be a result of untreated neovascularization in the retina?

Blurry vision and potential retinal detachment Signup and view all the answers

How does vitrectomy aid surgeons during eye surgery?

By improving visibility and allowing treatment of the retina Signup and view all the answers

What is the primary function of the cornea in the refractive apparatus of the eye?

To focus light onto the retina Signup and view all the answers

Which patient position is most commonly used during ophthalmology surgeries?

Supine position Signup and view all the answers

What is the role of dilating drops in ophthalmic surgeries?

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

What type of surgical instruments are typically counted as part of the minor count procedure in ophthalmology?

Extra capsular instruments for retinal surgeries Signup and view all the answers

Which of the following procedures best fits the use of intra capsular micro instruments?

Cataract surgery Signup and view all the answers

When collaborating with the surgical team, what key aspect should the perioperative nurse ensure regarding patient positioning?

The patient is securely positioned before, during, and after surgery Signup and view all the answers

Which statement accurately describes the aqueous humour?

It maintains intraocular pressure and nourishes the cornea Signup and view all the answers

In what context is the term 'minor count' used during ophthalmic surgeries?

Counting instruments for procedures such as cataracts and retinal surgeries Signup and view all the answers

Why is constant description and reinforcement critical for visually impaired patients during the pre-operative phase?

To reduce anxiety and improve focus on surgery Signup and view all the answers

Which of the following best describes the function of the vitreous humour in the eye?

It provides structural support and maintains eye shape Signup and view all the answers

Study Notes

Anatomy of the Eye

Bony orbit consists of seven bones: maxilla, palatine, frontal, sphenoid, zygomatic, ethmoid, and lacrimal.
The orbit houses the globe, orbital fat, extraocular muscles, nerves, blood vessels, and part of the lacrimal system.
Lacrimal glands produce tears, which flow through ducts to the ocular surface, aiding in moisture and debris removal.
Eyelid anatomy includes skin, ocular adnexa (eyelashes and glands), subcutaneous tissue, lymphatics, and muscles.
Conjunctiva is a thin membrane with palpebral (inner eyelids) and bulbar (surface of the globe) portions.
Extraocular muscles include four recti and two oblique muscles, working in pairs to control eye movements.
The globe is filled with aqueous humor (anterior) and vitreous humor (posterior) and is cushioned by orbital fat.

Refractive Apparatus of the Eye

The key components affecting vision include the cornea, lens, vitreous humor, and aqueous humor.

Perioperative Nursing Considerations

Patients vary widely in age, from premature infants to elderly individuals.
Clear communication is especially crucial for visually impaired patients during pre-operative phases.
Patient positioning during surgery typically requires a supine position; however, this can vary based on the procedure and surgeon preferences.
Collaboration between the perioperative nurse and surgical team promotes patient safety regarding positioning.

Instrumentation for Surgery

Instrument types include extracapsular instruments for retinal and muscle surgeries, micro instruments for cataract surgeries, and specific tools like eye scalpels, speculum, and corneal scissors.
Surgical procedures require a minor count of instruments—initial, closing, and final counts.

Ophthalmic Pharmacology

Dilating drops are used pre-operatively to facilitate pupil dilation for surgeries.
Cryotherapy and lasers are essential for treating retinal conditions and performing cataract surgeries.
Operating microscopes provide necessary magnification and illumination during procedures.

Surgical Interventions

Extraocular Surgeries: Address issues with the eye's muscles; common in strabismus treatment.
- Strabismus surgery repairs ocular misalignment, categorized by types: esotropia, exotropia, hypertropia, and hypotropia.
- Two techniques: recession (weaken the muscle) and resection (strengthen the muscle).
Enucleation: Total eyeball removal, indicated for painful eyes, tumors, or trauma; includes an implant for prosthesis support.
Chalazion Removal: Surgical intervention to remove meibomian gland obstructions.
Entropion and Ectropion Repairs: Correct inverted (entropion) or sagging (ectropion) eyelids.

Retinal Surgery Procedures

Vitreous fluid changes with age; increased floaters may indicate retinal issues.
Laser treatment can address diabetic retinopathy by coagulating abnormal vessels.
Vitrectomy: Removal of the vitreous gel to improve visibility and treatment of underlying conditions.
Pneumatic retinopexy: Intraocular gas injection to support retina reattachment.
Scleral buckling: External procedure to reattach the retina using silicone.

Intraocular Surgeries

Cataract Surgery: Involves lens removal and replacement; methods include ECCE and ICCE.
ECCE entails controlled rupture of the capsule while ICCE involves removing the lens within its capsule.

ORNAC Laser Safety Standards

Follow strict protocols and maintain a controlled environment during laser procedures.
Ensure personal protective equipment is available, including labeled laser safety eyewear.
Maintain communication and documentation throughout the procedure to ensure safety protocol adherence.

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Description

This quiz covers key concepts from Module 23, focusing on ophthalmology and laser surgery based on Alexander's Care of the Patient in Surgery and related readings. Test your understanding of eye anatomy and surgical procedures relevant to this specialty.