Ophthalmology and Laser Surgery Quiz

Anatomy of the Eye

• The bony orbit comprises 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 apparatus.
• Lacrimal glands produce tears that flow through ducts to the cornea, draining into the nasolacrimal duct.
• The eyelid includes skin, ocular adnexa, subcutaneous tissue, lymphatics, and muscles.
• The conjunctiva is a transparent mucous membrane, with palpebral (lining eyelids) and bulbar (covering the globe) portions.
• Extraocular muscles consist of four recti (superior, inferior, medial, lateral) and two oblique muscles (superior and inferior), controlling eye movements.

Surgical Interventions and Medications

• Intraocular surgeries use viscoelastic agents like sodium hyaluronate to protect corneal tissues and maintain separation.
• Miotics (e.g., Miochol) constrict pupils during anterior segment surgeries.
• Balanced Salt Solution (BSS) maintains corneal moisture and can include epinephrine for bleeding prevention.
• Mannitol and other hyperosmotic agents lower intraocular pressure during surgery.
• Injectable anesthetics (Lidocaine, Bupivacaine) are used, typically with different concentrations of epinephrine.

Eye Medication Considerations

• Be cautious with similar-named eye medications, such as 5-Fluorouracil and Mitomycin, which are used to prevent scarring in glaucoma surgery.

Equipment for Ophthalmic Surgery

• Phacoemulsification machines use ultrasound for cataract surgery, along with irrigation and aspiration techniques.
• Posterior vitrectomy machines assist in vitrectomy procedures, gently removing vitreous near sensitive regions of the eye.

Laser Surgery Fundamentals

• Laser stands for "Light Amplification by Stimulated Emission of Radiation" and converts electrical energy into optical energy.
• Medical lasers enable precise surgical operations by focusing intensely on small tissue areas.
• Characteristics of laser light include:
  • Collimated: Concentrated light focused over long distances with parallel waves.
  • Coherent: Organized waves traveling in the same direction, enhancing power.
  • Monochromatic: Light of a single color or wavelength, unlike ordinary light.

Types of Lasers

• Commonly used lasers include CO2, Holmium/YAG, and Green Light KTP lasers.

Laser Operation Modes

• Continuous Wave (CW): Consistent output with a steady pump source.
• Pulsed Operation: Energy output varies, ideal for delivering high energy in short bursts.

Laser Safety Classifications

• Class I: Safe devices (e.g., CD players).
• Class II: Safe during normal use (e.g., laser pointers).
• Class III: Risk of eye damage; requires safety measures.
• Class IIIb: Immediate severe eye damage risk; eye protection required.
• Class IV: Industrial lasers with potential for serious harm; strict safety protocols necessary.

ORNAC Laser Safety Standards

• Follow safety checklists for laser procedures.
• A dedicated circulating nurse is needed during operations.
• Limit access to authorized personnel, marked with warning signs.
• Personal protective equipment, including laser-specific eye guards, must be available.
• Ensure the environment is maintained to minimize reflective surfaces and hazards.

Test your knowledge on the anatomy of the eye and explore various surgical interventions and procedures in ophthalmology. Based on readings from Alexander’s Care of the Patient in Surgery and Instrumentation for the Operating Room, this quiz covers key concepts and standards in the field. Enhance your understanding of eye care and laser surgery techniques.