Ch 16 case study's/further study/vocab

Balanced Salt Solution (BSS)

An irrigant used for the eye during eye procedures.

Cataract

A pathological condition in which the crystalline lens has become opaque due to age or trauma.

Chalazion

A small, red, inflamed lump that can be located on the inner surface of the eyelid; caused by an inflammatory reaction to material trapped inside the meibomian gland in the eyelid.

Dacryo-

lacrimal sac, tears

Diathermy

The use of high frequency electromagnetic currents to cauterize blood vessels & destroy neoplasm.

Enucleation

En bloc removal of a structure; usually refers to the removal of the eye.

Globe

The eyeball in its entirety.

Strabismus

A pathological condition that is a misalignment or deviation of the eyes that normally work simultaneously to track visual objects.

Trephine

A cylindrical saw for cutting a circular piece of bone.

Tunic

An investing membrane.

ocutome

cutting instrument used in a vitrectomy

Susan is admitted to the hospital for eye surgery. She was diagnosed in childhood with diabetes and is now 50 years old. Susan has also been diagnosed with retinopathy, a frequently occurring condition in diabetic patients. Her vision has been deteriorating over the last several years. She has recently suffered a vitreous hemorrhage due to neovascularization of the eye, which is common in diabetic patients.

What procedure will be performed to resolve the problem?

vitrectomy

Susan is admitted to the hospital for eye surgery. She was diagnosed in childhood with diabetes and is now 50 years old. Susan has also been diagnosed with retinopathy, a frequently occurring condition in diabetic patients. Her vision has been deteriorating over the last several years. She has recently suffered a vitreous hemorrhage due to neovascularization of the eye, which is common in diabetic patients.

Briefly describe the procedure, and explain how Susan will benefit.

vitreous humor that fills the cavity is removed by the use of a fiberoptic light and vitrector. this allows better access to the retina.

benefits: reduces risk of retinal tear, retinal detachment, macular edema, and other complications

Susan is admitted to the hospital for eye surgery. She was diagnosed in childhood with diabetes and is now 50 years old. Susan has also been diagnosed with retinopathy, a frequently occurring condition in diabetic patients. Her vision has been deteriorating over the last several years. She has recently suffered a vitreous hemorrhage due to neovascularization of the eye, which is common in diabetic patients.

what are the possible approaches that the surgeon may use to enter the eye? which is preferred?

small incisions made in eye, laser, vitreoretinal surgical and laser approaches

trans pars planar is preferred

Susan is admitted to the hospital for eye surgery. She was diagnosed in childhood with diabetes and is now 50 years old. Susan has also been diagnosed with retinopathy, a frequently occurring condition in diabetic patients. Her vision has been deteriorating over the last several years. She has recently suffered a vitreous hemorrhage due to neovascularization of the eye, which is common in diabetic patients.

what piece of equipment is crucial to a vitrectomy?

vitrector

Susan is admitted to the hospital for eye surgery. She was diagnosed in childhood with diabetes and is now 50 years old. Susan has also been diagnosed with retinopathy, a frequently occurring condition in diabetic patients. Her vision has been deteriorating over the last several years. She has recently suffered a vitreous hemorrhage due to neovascularization of the eye, which is common in diabetic patients.

what substance, if any, will be used to replace the vitreous humor?

C3F8, SF6

silicone oil, sodium hyaluronate, bss

Ronald has been having trouble with his stereoscopic vision. His wife says that he appears to have a lazy eye. The amount of misalignment seems to be the same, no matter which direction his eyes are looking. Ronald has been admitted to the ambulatory care center for surgery.

What is the correct term for the condition that Ronald has?

strabismus

Ronald has been having trouble with his stereoscopic vision. His wife says that he appears to have a lazy eye. The amount of misalignment seems to be the same, no matter which direction his eyes are looking. Ronald has been admitted to the ambulatory care center for surgery.

what is the name of his condition?

amblyopia

Ronald has been having trouble with his stereoscopic vision. His wife says that he appears to have a lazy eye. The amount of misalignment seems to be the same, no matter which direction his eyes are looking. Ronald has been admitted to the ambulatory care center for surgery.

what surgical procedure will be performed to correct this condition?

R&R (recession and resection)

Ronald has been having trouble with his stereoscopic vision. His wife says that he appears to have a lazy eye. The amount of misalignment seems to be the same, no matter which direction his eyes are looking. Ronald has been admitted to the ambulatory care center for surgery.

in which position will Ronald be placed for the procedure?

supine, slight trendelenberg may be used, towel placed under shoulders, head rest, arms tucked

Ronald has been having trouble with his stereoscopic vision. His wife says that he appears to have a lazy eye. The amount of misalignment seems to be the same, no matter which direction his eyes are looking. Ronald has been admitted to the ambulatory care center for surgery.

what are the anatomical boundaries for the prep?

Prep is typically done bilaterally. Boundaries are from hairline to inferior mandibular border and from the anterior auricular border to beyond the midline.

Hairline-inferior mandibular-anterior auricular border-midline

A 35 year old female patient is complaining of pain in her left eye, including the area between the eye and nose with redness and inflammation. The area is sensitive to touch, and there has been a discharge from the medial corner of her eye for a few days. After several weeks of conservative therapy, she is referred to an ophthalmic surgeon for treatment.

what is the likely diagnosis?

dacryocystitis

A 35 year old female patient is complaining of pain in her left eye, including the area between the eye and nose with redness and inflammation. The area is sensitive to touch, and there has been a discharge from the medial corner of her eye for a few days. After several weeks of conservative therapy, she is referred to an ophthalmic surgeon for treatment.

what surgical procedure will likely be performed?

dacryocystorhinostomy

A 35 year old female patient is complaining of pain in her left eye, including the area between the eye and nose with redness and inflammation. The area is sensitive to touch, and there has been a discharge from the medial corner of her eye for a few days. After several weeks of conservative therapy, she is referred to an ophthalmic surgeon for treatment.

describe the steps of the procedure, including the medications that are specific to the procedure.

A 73 year old male patient complains of progressive darkening and clouding across his entire left field of vision. The patient reports no pain or trauma, and the progression has taken place very gradually. He is diagnosed with a cataract in the left eye.

what surgical procedure will be performed in this case?

cataract extraction (extracapsular)

A 73 year old male patient complains of progressive darkening and clouding across his entire left field of vision. The patient reports no pain or trauma, and the progression has taken place very gradually. He is diagnosed with a cataract in the left eye.

describe how the microscope will be draped.

use caution to avoid breaking sterile technique

A 73 year old male patient complains of progressive darkening and clouding across his entire left field of vision. The patient reports no pain or trauma, and the progression has taken place very gradually. He is diagnosed with a cataract in the left eye.

why is it important that all personnel in this procedure wear powder free gloves?

powder can cause corneal irritation and adhesions

A 73 year old male patient complains of progressive darkening and clouding across his entire left field of vision. The patient reports no pain or trauma, and the progression has taken place very gradually. He is diagnosed with a cataract in the left eye.

what is the likely postoperative treatment plan for the patient?

antibiotic eye drops, rigid eye shield, dark glasses, in 1-3 days patient may resume normal activity

what type of energy is used during phacoemulsification?

ultrasonic energy that helps break up the lens

list two possible complications of intraocular gas injection

accelerated progression of existing cataracts and increased IOP

what is meant by the term retrobulbar block?

injection of local anesthetic behind globe to paralyze extrinsic muscles