Ophthalmology

Question 1

state roles of ophthalmology nurse

Answer 1

prepare for procedures
cleaning and maintenance of delicate equipment
eye care
surgical anaesthesia
monitoring

Question 2

describe what is seen in normal conformation of eyes

Answer 2

almond shaped

small amount of white laterally

Question 3

list some signs of abnormal eye anatomy

Answer 3

white seen ventrally or dorsally
abnormal pupil shape
unequal pupils

Question 4

list equipment needed for ophthalmic exams

Answer 4

dark room
pen torch
direct ophthalmoscope
20D condensing lens
tonotometer
consumables- fluorescein, schrimer tear test strips

Question 5

describe how to restrain patients for eye exam

Answer 5

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

Question 6

how should you approach blind patients?

Answer 6

speak as approaching

move slowly

Question 7

what measures should be taken for patients with high IOP?

Answer 7

avoid increasing IVP
use harness not collar
no jugular samples
sedate

Question 8

list history that needs taking for ophthalmic patients

Answer 8

signalment
general history
other illnesses
current and previous eye conditions and treatment
vision

Question 9

what is looked at in direct and close exam of eye patients?

Answer 9

animals body condition
symmetry of face and eyes
ocular discharge
eyelids
pupils 
retroillumination with ophthalmoscope

Question 10

what is the purpose of neuro-ophthalmic exams?

Answer 10

test vision and reflexes

Question 11

what light detection tests are done in neuro-ophthalmic exam?

Answer 11

pupillary light reflex

dazzle reflex

Question 12

what vision tests are done in neuro-ophthalmic exams?

Answer 12

menace response
tracking response
visual placing
maze test in bright and dim light

Question 13

what is the purpose of close direct ophthalmoscopy?

Answer 13

use magnification to look at ocular structures details

Question 14

what is meant by indirect ophthalmoscopy?

Answer 14

observing eyes from further away

Question 15

list common ophthalmological diagnostic tests

Answer 15

schrimer tear test
bacterial swab, culture, sensitivity, cytology
fluorescein staining
IOP measurement
gonioscopy
ocular ultrasound
electroretinogram
CT and MRI

Question 16

what is the normal result for dogs schrimer tear test over a minute?

Answer 16

15-25mm

Question 17

what is normal IOP?

Answer 17

10-25mmHg

Question 18

what is needed to measure IOP?

Answer 18

schiotz tonometer
tonopen
tonovet
LA

Question 19

when is gonioscopy indicated?

Answer 19

risk of inherited glaucoma
confirmed glaucoma
causes high IOP

Question 20

what can be seen in CT and MRI of eyes?

Answer 20

retrobulbar abscesses
retrobulbar neoplasia
foreign body

Question 21

what does OS stand for and what does it mean?

Answer 21

ocular sinister

left eye

Question 22

what does OD stand for and what does it mean?

Answer 22

ocular dexter

right eye

Question 23

what does OU stand for and what does it mean?

Answer 23

ocular uterque

both eyes

Question 24

describe the process of administering eye drops

Answer 24

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

Question 25

what shows non-painful eyes?

Answer 25

wide even eyes almond shaped no discharge

Question 26

list some signs of painful eyes

Answer 26

``` discharge uneven eyes ulcers and scratches blepharospasm increased tear production light sensitivity 3rd eyelid protrusion ```

Question 27

define blepharospasm

Answer 27

involuntary blinking or twitching of eyelids

Question 28

what is the purpose of eye lubricants?

Answer 28

provide protective layer sooth eyes lubricate eyes

Question 29

when are eye lubes used?

Answer 29

almost all patients in surgery as no contraindications

Question 30

what do mydriatics do?

Answer 30

relief long term or during eye exams pupil dilation muscle spasm release increase comfort

Question 31

when are topical antibiotics uses in eyes?

Answer 31

treat or prevent bacterial infection

Question 32

what do topical NSAIDs for eyes do?

Answer 32

treat eye inflammation

Question 33

what do carbonic anhydrase inhibitors do when applied to eyes?

Answer 33

reduce IOP | decrease production of aqueous humour

Question 34

what do prostaglandin analogues do for the eyes?

Answer 34

increase aqueous outflow

Question 35

list features of pre-anaesthetic checklist for eye surgery patients?

Answer 35

``` physical exam blood tests ocular anaesthetic opioid drops to reduce tear production IV care if IOP high insulin if diabetic ```

Question 36

when is the only time you need to clip eyelids for eye surgery?

Answer 36

if operating on eyelids

Question 37

when do you need to prepare globe for surgery?

Answer 37

only if operating on globe not surrounding area

Question 38

what is used to prep eye area and what concentrations?

Answer 38

povidone iodine globe- 1:50 eyelids- 1:10

Question 39

describe how eyelids are prepped for surgery

Answer 39

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

Question 40

describe prep for intraocular surgery

Answer 40

wear gloves prep globe with povidone iodine after 3 minutes flush globe with sterile saline to prevent corneal toxicity

Question 41

list theatre prep needed before ophthalmic surgery

Answer 41

damp dust everything set up ventilator (as neuromuscular blocking agents used may inhibit respiration) operating microscope, equipment and consumables

Question 42

describe how to clean microsurgical instruments

Answer 42

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

Question 43

state post op considerations for eye surgery patients

Answer 43

``` harness no jugular samples buster collar analgesia eye medications wound care ```

Question 44

what is exophthalmos?

Answer 44

abnormal protrusion of the eyeball

Question 45

what causes exophthalmos?

Answer 45

orbital foreign body tumour abscess

Question 46

what is globe proptosis?

Answer 46

protruded eye with eyelids trapped behind the globe

Question 47

what is first aid for globe proptosis?

Answer 47

keep eye moist | get to practice quickly

Question 48

define entropion

Answer 48

inverted eyelids

Question 49

what are causes of entropion?

Answer 49

primary | secondary to trauma or surgery

Question 50

what is keratoconjunctivitis sicca?

Answer 50

dry eyes due to lack of tear production

Question 51

what are signs of keratoconjunctivitis sicca?

Answer 51

mucus discharge pigmentation new blood vessels

Question 52

how is keratoconjunctivitis sicca diagnosed?

Answer 52

schrimer tear test

Question 53

how is keratoconjunctivitis sicca treated?

Answer 53

topical medication to lubricate eyes | life long treatment

Question 54

list common ocular problems

Answer 54

``` exophthalmos globe protrusion entropion keratoconjunctivitis sicca corneal ulcers conjunctivitis uveitis cataract retinal detachment ```

Question 55

define conjunctivitis

Answer 55

inflammation of conjunctiva

Question 56

define uveitis

Answer 56

inflammation of white of eye

Question 57

define cataract

Answer 57

increased opacity of the lens

Question 58

what is most common cause of retinal detachment?

Answer 58

secondary to renal failure