Ophthalmology Flashcards
state roles of ophthalmology nurse
prepare for procedures cleaning and maintenance of delicate equipment eye care surgical anaesthesia monitoring
describe what is seen in normal conformation of eyes
almond shaped
small amount of white laterally
list some signs of abnormal eye anatomy
white seen ventrally or dorsally
abnormal pupil shape
unequal pupils
list equipment needed for ophthalmic exams
dark room pen torch direct ophthalmoscope 20D condensing lens tonotometer consumables- fluorescein, schrimer tear test strips
describe how to restrain patients for eye exam
hold at edge of table with one hand over back and round to chest and other holding up chin
minimal restraint as possible but may need muzzle or sedation
how should you approach blind patients?
speak as approaching
move slowly
what measures should be taken for patients with high IOP?
avoid increasing IVP
use harness not collar
no jugular samples
sedate
list history that needs taking for ophthalmic patients
signalment general history other illnesses current and previous eye conditions and treatment vision
what is looked at in direct and close exam of eye patients?
animals body condition symmetry of face and eyes ocular discharge eyelids pupils retroillumination with ophthalmoscope
what is the purpose of neuro-ophthalmic exams?
test vision and reflexes
what light detection tests are done in neuro-ophthalmic exam?
pupillary light reflex
dazzle reflex
what vision tests are done in neuro-ophthalmic exams?
menace response
tracking response
visual placing
maze test in bright and dim light
what is the purpose of close direct ophthalmoscopy?
use magnification to look at ocular structures details
what is meant by indirect ophthalmoscopy?
observing eyes from further away
list common ophthalmological diagnostic tests
schrimer tear test bacterial swab, culture, sensitivity, cytology fluorescein staining IOP measurement gonioscopy ocular ultrasound electroretinogram CT and MRI
what is the normal result for dogs schrimer tear test over a minute?
15-25mm
what is normal IOP?
10-25mmHg
what is needed to measure IOP?
schiotz tonometer
tonopen
tonovet
LA
when is gonioscopy indicated?
risk of inherited glaucoma
confirmed glaucoma
causes high IOP
what can be seen in CT and MRI of eyes?
retrobulbar abscesses
retrobulbar neoplasia
foreign body
what does OS stand for and what does it mean?
ocular sinister
left eye
what does OD stand for and what does it mean?
ocular dexter
right eye
what does OU stand for and what does it mean?
ocular uterque
both eyes
describe the process of administering eye drops
check medication and correct eye
clean away discharge
hold bottle in dominant thumb and fingers
other hand supports chin and holds up slightly
use fingers holding bottle to lift eyelids gently then squeeze bottle with hand resting on head to prevent bottle touching eye
if tolerates hold in position to allow drops to disperse
what shows non-painful eyes?
wide even eyes
almond shaped
no discharge
list some signs of painful eyes
discharge uneven eyes ulcers and scratches blepharospasm increased tear production light sensitivity 3rd eyelid protrusion
define blepharospasm
involuntary blinking or twitching of eyelids
what is the purpose of eye lubricants?
provide protective layer
sooth eyes
lubricate eyes
when are eye lubes used?
almost all patients in surgery as no contraindications
what do mydriatics do?
relief long term or during eye exams
pupil dilation
muscle spasm release
increase comfort
when are topical antibiotics uses in eyes?
treat or prevent bacterial infection
what do topical NSAIDs for eyes do?
treat eye inflammation
what do carbonic anhydrase inhibitors do when applied to eyes?
reduce IOP
decrease production of aqueous humour
what do prostaglandin analogues do for the eyes?
increase aqueous outflow
list features of pre-anaesthetic checklist for eye surgery patients?
physical exam blood tests ocular anaesthetic opioid drops to reduce tear production IV care if IOP high insulin if diabetic
when is the only time you need to clip eyelids for eye surgery?
if operating on eyelids
when do you need to prepare globe for surgery?
only if operating on globe not surrounding area
what is used to prep eye area and what concentrations?
povidone iodine
globe- 1:50
eyelids- 1:10
describe how eyelids are prepped for surgery
wear gloves
apply lots of lube to eye
clip eyelid with sharp clippers
remove hair and gel from eyes with gauze swabs and sterile saline
prep globe and eyelids with povidone iodine
after 3 minutes flush globe with sterile saline to prevent cornea toxicity
describe prep for intraocular surgery
wear gloves
prep globe with povidone iodine
after 3 minutes flush globe with sterile saline to prevent corneal toxicity
list theatre prep needed before ophthalmic surgery
damp dust everything
set up ventilator (as neuromuscular blocking agents used may inhibit respiration)
operating microscope, equipment and consumables
describe how to clean microsurgical instruments
remove gross material with distilled water and soft brush
check for damage
place in ultrasonic cleaner for 5-10 minutes with neutral pH cleaner on finger mat
air dry
autoclave on silicone finger mat
store flat
state post op considerations for eye surgery patients
harness no jugular samples buster collar analgesia eye medications wound care
what is exophthalmos?
abnormal protrusion of the eyeball
what causes exophthalmos?
orbital foreign body
tumour
abscess
what is globe proptosis?
protruded eye with eyelids trapped behind the globe
what is first aid for globe proptosis?
keep eye moist
get to practice quickly
define entropion
inverted eyelids
what are causes of entropion?
primary
secondary to trauma or surgery
what is keratoconjunctivitis sicca?
dry eyes due to lack of tear production
what are signs of keratoconjunctivitis sicca?
mucus discharge
pigmentation
new blood vessels
how is keratoconjunctivitis sicca diagnosed?
schrimer tear test
how is keratoconjunctivitis sicca treated?
topical medication to lubricate eyes
life long treatment
list common ocular problems
exophthalmos globe protrusion entropion keratoconjunctivitis sicca corneal ulcers conjunctivitis uveitis cataract retinal detachment
define conjunctivitis
inflammation of conjunctiva
define uveitis
inflammation of white of eye
define cataract
increased opacity of the lens
what is most common cause of retinal detachment?
secondary to renal failure
