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RUSVM Small Animal Surgery 2017 > Ophthalmic Surgery > Flashcards

Ophthalmic Surgery Flashcards

1
Q

How do you prepare eyelids for surgery?

A

Lubrication gel
Clip the periorbital hair and eyelids
Scrub periocular area with a 0.2% iodine/saline solution and sterile saline
Clean conjunctiva and nictitating membrane with cotton swab
Irrigate cornea

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2
Q

What should you avoid with surgical preparation of the eyes?

A

Avoid scrub on the cornea

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3
Q

What are the basic ophthalmic intrustruments?

A 
Barraquer eyelid speculum
Jaeger eyelid plate
Bishop-Harmon forceps
Derf needle holder
Stevens tenotomy scissors
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4
Q

What do you do for Hemostasis of the eye?

A 
Direct pressure with cotton tip applicators
Wedge shaped cellulose sponges
4x4 sponges
Hand held cautery 
Phenylephrine
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5
Q

What are common surgical disease of the eyelids?

A 
Eyelid lacerations
Eyelid tumors
Eyelid agenesis
Entropion 
Ectropion
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6
Q

How do you manage eyelid lacerations?

A

Close in 2 layers
Deep layer: Simple continuous
Skin: Figure 8

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7
Q

What is important for closing the skin of the eyelid?

A

Place knots away from cornea

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8
Q

What suture should you used in closure of the skin of the eyelid?

A

5/0 or 6/0 Vicryl

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9
Q

What do you do for a mass of the eyelid that is less than 1/3 the eyelid margin?

A

treat like a laceration

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10
Q

What is the technique for Canine Eyelid tumor resection?

A

H shaped resection

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11
Q

What are the techniques for Eyelid Reconstruction?

A

Single Pedicle advancement flap

Lip to Lid flap

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12
Q

What are the most common feline eyelid tumors?

A

Squamous cell carcinoma

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13
Q

Eyelid Agenesis

A

Upper lateral or lower central eyelid defect in felines

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14
Q

What is the technique used to treat Eyelid Agenesis?

A

Dziezye-Millichamp Mucocutaneous Pedicle Graft

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15
Q

Entropion

A

Inward turning of the eyelid margin

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16
Q

What are the clinical signs of Entropion?

A 
Asymptomatic 
Ocular discharge
Epiphora
Self trauma
Corneal erosion 
ulceration 
visual deficits
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17
Q

What are the characteristics for Congenital Entropion?

A

Bilateral

Lower lateral lid

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18
Q

In what species is Entropion common?

A

dogs

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19
Q

In what age do you commonly see Entropion in dogs?

A

Less than 6 months

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20
Q

At what age do you correct Entropion in dogs?

A

after 8 months of age

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21
Q

What are the predisposing factors of Entropion?

A

Size of the globe
Globe position in orbit
Length of palpebral fissure
Tone of orbicularis m.

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22
Q

What are the breeds that are predisposed to Entropion?

A

Chow Chow
Shar-Pei
Saint Bernard

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23
Q

What is the Acquired Form of Entropion associated with?

A

Lid Spasm

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24
Q

What are the characteristics of Acquired Entropion?

A

Unilateral

at any age

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25
Q

What are the surgical options for Entropion?

A

Eyelid tacking
Hotz-Celsus
Modified Hotz-Celsus
Arrowhead resection

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26
Q

What suture do you use for the Hotz-Celsus Technique?

A

5/0 PDS

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27
Q

What suture do you use for Eyelid Tacking?

A

3/0-5/0 PDS

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28
Q

What suture pattern is used for eyelid tacking?

A

Interrupted Lembert

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29
Q

What do you use the Modified Hotz-Celsus Procedure for?

A

Medial canthal entropion

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30
Q

Ectropion

A

Eversion of the eyelid

31
Q

In what breeds are Ectropion congenital in?

A

Saint Bernard

Bloodhound

32
Q

What causes Acquired Ectropion?

A

Contraction of scar tissue

Overcorrection of entropion

33
Q

When do you treat Ectropion?

A

when the animal develops signs of Keratitis, Conjuncitivitis

34
Q

What techniques are used for treatment of Ectropion?

A

Wedge Resection

V-Y Blepharoplasty

35
Q

What are the clinical signs of Nasolacrimal System?

A

Epiphora
Periorbital alopecia and tear staining
Mucopurulent ocular discharge/conjunctivitis

36
Q

What are the diagnostic tests for Nasolacrimal system?

A 
Jones 1 Test
Nasolacrimal flushing 
Dacryocystorhinography 
CT
MRI
37
Q

What are the disease of Nasolacrimal System?

A 
Punctal aplasia
Micropunctum
Trauma
and scaring
KCS
38
Q

What is the most commonly reported congenital anomaly of the drainage system in dogs?

A

Punctal aplasia and Micropunctum

39
Q

What are the clinical signs of Punctal aplasia and Micropunctum?

A

Epiphora

Tear staining

40
Q

What are the functions of the Nictitating Membrane?

A

Tear production
Protect globe
Removes debris from cornea

41
Q

What are the surgical diseases of the Nictitating Membrane?

A

Everting nictitating membrane
Prolapsed nictitating membrane (cherry eye)
Neoplasia

42
Q

What is the most common disorder of the 3rd eyelid?

A

Prolapsed Nictitating Membrane

43
Q

What are the surgical options for Prolapsed Nictitating Membrane?

A

Orbital rim anchoring technique

Pocket technique

44
Q

What solution do you use to prep for ophthalmic surgery?

A

0.2% Iodine solution

.05% Chlorohexadine gluconate and alternate with saline

45
Q

What recumbency would you use to perform ophthalmic surgery on both eyes?

A

Sternal recumbency

46
Q

What recumbency would you use to perform ophthalmic surgery on one eye?

A

Lateral recumbency

47
Q

What would you use a Barraquer eyelid speculum for in ophthalmic surgery?

A

placed under the lower and upper lid for better examination

48
Q

What would you use a Jaeger eyelid plate for in ophthalmic surgery?

A

between the eyelid and the globe to protect and flatten out the eyelid

49
Q

What would you use a Bishop Harmon Forceps for in ophthalmic surgery?

A

grasp conjunctival tissue

50
Q

What would you use Derf needle holders for in ophthalmic surgery?

A

secures smaller needles and smaller suture

51
Q

What would you use Stevens tenotomy scissors for in ophthalmic surgery?

A

Scissors used specifically for ophthalmic procedures because they are sharp and pointed

52
Q

Why do you not usually use gauze and cotton tipped swabs in ophthalmic procedures?

A

they shed fibers and irritate the eye

53
Q

Why would you use epinephrine in ophthalmic surgery?

A

Use to vasconstrict bleeders

54
Q

What MUST you achieve with correction of Eyelid lacerations?

A

proper occlusion of the commissures to reduce KCS and irritation

55
Q

What two patterns do you use with eyelid lacerations?

A
  1. simple continuous

2. figure 8 pattern

56
Q

Why do we use the figure 8 pattern in eyelid lacerations?

A

to provide anatomical alignment and bring the suture tags away from the commissure to reduce irritation

57
Q

Why would you use Vicryl in the figure 8 pattern from eyelid lacerations?

A

it is soft and can be exposed to the cornea

58
Q

Exopytic

A

growing outward from the skin

59
Q

What is the advantage of using the H shaped resection?

A

preserves some of the eyelid

decreases the chance of performing eyelid reconstruction

60
Q

When would you use the semi circular flap for eyelid reconstruction?

A

lateral defects of the upper or lower lid

61
Q

What is the most common eyelid affected by agenesis?

A

upper lateral eyelid

62
Q

What is the most common form of Entropion in dogs?

A

Congenital

63
Q

What suture patterns would you use with the Hotz Celsus Technique Incision Method?

A

Simple Continuous pattern

Simple Interrupted

64
Q

What is a disadvantage to using the Modified Hotz Celsus procedure?

A

Can cause problems with tear drainage

65
Q

What is an advantage to the Modified Hotz Celsus procedure?

A

Can open the caniculi and improve appropriate draining and reduce tear staining

66
Q

What is the common cause of Ectropion?

A

Congenital

67
Q

What does the Dacryocystohinography test for?

A

Cyst or neoplasia where the lacrimal gland runs through

68
Q

What is the cause of Prolapsed Nictitating Membrane?

A

loss of structure of the connective tissue around the gland of the third eyelid

69
Q

What does Prolapsed Nictitating membrane predispose to?

A

KCS

Mucopurulent discharge

70
Q

What are the disadvantages of enclosing the Nictitating membrane entirely?

A

seroma formation

71
Q

When would you use a transpalpebral approach for enucleation?

A

Neoplasia

72
Q

If 2 or more muscles are avulsed it indicates what?

A

you have compromised blood supply to the globe itself

73
Q

How should you treat a Proptosis with alot of pain?

A

enucleate

RUSVM Small Animal Surgery 2017 (17 decks)

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