Exam 2 Ophthalmic sx Flashcards
How does surgical preparation differ in ophthalmic surgery
Due to:
delicate thin skinned eyelids
Cornea & conjunctiva are damaged by alcohol & detergents
Bacterial flora present on ocular sufaces
Deep conjunctiva& 3rd eyelid harbors hairs and pathogens
What type of surgical prep solutions are acceptable for ophthalmic surgery
1:50 (0.2%) iodine\saline solution
Alternate with sterile saline
What are other important components for surgery of the eyes
Surgeon seated with armrests
Magnification
What are the names and uses for ophthalmic instruments discussed in class
Barraquer eyelid speculum
Jaeger eyelid plates
Bishop-Hrmon forceps
Derf needle holder
Stevens tenotomy scissors
What are methods of hemostasis in ophthalmic surgery
Direct pressure with cotton tipped applicators
Wedge shaped cellulose sponges
Handheld cautery
Phenylephrine
1:10,000 epi
How many layers do you close eyelid lacerations in
Two layers
The deep layer is through muscle and fibrous tissue, avoid conjunctiva
What are the skin suture patterns of eyelids
Suture type
Figure 8
5\0 or 6\0 Vicryl
What % of eyelid tumors in dogs are benign
73%
What is a really common benign mass of the eyelid
Meibomian gland adenoma
What is the most amount of eyelid you can remove and have a primary closure
1/3
What are the signs, types and treatments of entropion and when do you treat
Ocular discomfort
Epiphora
Self-trauma
Corneal erosion, ulceration and visual deficits
eyelid tacking, Hotz Celsus (hemostat, incision), modified Hotz-Celsus, arrowhead resection
if congenital >8 months of age
What is acquired entropion asociated with
Lid spasm
- Corneal ulcers
- KCS
- FB
What are the sx of entropion
eyelid tacking
Hotz Celsus
Modified Hotz Celsus
Arrowhead resection
What sx is used for medial canthal entropion
Modified Hotz-Celsus
How & when do you tx ectropion
Most do not require tx
tx those that develop signs:
Keratitis
Conjunctivitis
Wedge resection
V-Y blepharoplasty
What are the most common dz of th nasolacrimal system & signs associated with them
Most Common:
Punctal aplasia
micropunctum
trauma & scarring
KCS
CS include:
epiphora & tear staining
How do you dx disease/trauma of the nasolacrimal system
Jones 1 test
Nasolacrimal flushing
dacryocystorhinography
CT, MRI
How do you tx diseases/trauma of the nasolacrimal system
unblock duct/resect
trauma:
bubble test -> cannulate & suture
what is the function of nicitating membrane
tear production
protect globe
remove debris from cornea
what is the most common disorder of the 3rd eyelid
Prolapes nictitating membrane (cherry eye)
What are the procedures for prolapsed nictitating membrane
excision (not recommended)
orbital rim anchoring technique -more technically difficult
Pocket technique
when & how do you enuculate and eye
Painful non visual eye
neoplasia & non responsive infections
subconjunctival approach
transpalpebral approach
what is exenteration
complete removal of eye & socket contents!
done for neoplasia
What is proptosis & how to manage it
sudden blow to orbit incr. IOP, eyelid entraps posterior to globe
enucleate
manually reduce, temporary tarsorrhaphy
What and when do you perform a temporary tarsorrhaphy
suture eyelids closed together
lid reconstruction
entropion/ectropion correction
lacerations
mass removals
proptosis