SASx Final Exam - Ophthalmic Flashcards

1
Q

What procedure is used for large defects in the lower eyelid?

A

Lip to Lid Flap

  • Used for large defects in lower lid
  • Mucocutaneous flap made at 45 degree angle from canthi
  • Diverge so wider base
  • Bridging incision and suture
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2
Q

T/F: It may be acceptable to use scissors for making incisions in ophthalmic surgery

A

True

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3
Q

What is Dziezye Millichamp Mucocutaneous Pedicle Graft used for?

A

eyeild agenesis

Reconstruction technique used for eyelid agenesis

  • Separate away the conjunctival tissue from the skin where the eyelid is supposed to be
  • Take skin graft from lower (non-affected lid) and create bridging incision
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4
Q

What drug is often used to stop bleeding in eye surgery?

A

diluted epinephrine

1:10,000

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5
Q

How many layers are used to close eyelid lacerations?

A

Two

  • Deep layer:
    • ​Muscle & fibrous tissue
    • Bites perpendicular to eyelid
    • Avoid conjunctiva
    • Simple continuous pattern; absorbable suture
  • Skin
    • _​Figure of 8**_
      • ​Ensures apposition
      • Places knots away from cornea
    • Start 4 mm from eyelid margin, exit 1 mm from margin
    • 5-0 or 6-0 Vicryl
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6
Q

Inward turning of the eyelid margin is termed:

A

entropion

  • Clinical signs: Asymptomatic, Ocular discomfort, Epiphora, Self trauma, Corneal erosion, ulceration, and visual deficits
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7
Q

What procedure is used for full thickness lesions when conjunctiva is excised?

A

Single pedicle advancement and conjunctival graft

  • Used for full thickness lesions when conjunctiva is excised
  • Create conjunctival flap from opposite lid
  • Perform same advancement flap
  • Perform tarsorrhaphy (closing the eyelid to achieve minimal movement)
  • Cut graft in 2 weeks
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8
Q

What procedure is used for medial canthal entropion?

A

Modified Hotz-Celsus Procedure

  • Used for medial canthal entropion
  • Isolate lacrimal puncta - once you dirupt this, you’re going to f*** up your lacrimal apparatus (almost impossible to resolve)
  • Create triangle with ventral apex and suture
  • May decrease epiphora in some
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9
Q

Approximately what percentage of proptosed eyes regain vision?

A

~20%

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10
Q

What surgical option would be most indicated to temporarily fix entropion in a patient that has not reached facial maturity?

A

eyelid tacking

  • Patient not reached facial maturity
  • May resolve some cases
  • Use 3/0 – 5/0 PDS
  • Multiple interrupted Lembert patterns
  • Leave for 4 weeks or until of age for surgery
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11
Q

What is the greatest amount of eyelid you can remove and still have a primary closure?

A

1/3

Anything beyond that, you’ll have to perform some sort of reconstruction

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12
Q

Congenital entropion is usually bilateral and is more common in dogs. When would you perform surgery in these cases?

A

after 8 months of age

Best to wait until facial features are developed and mature

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13
Q

________ is the most common eyelid tumor in cats

A

squamous cell carcinoma (SCC)

  • Associated with light skinned cats and sun exposure
  • Prognosis is guarded
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14
Q

T/F: The surgical treatment of choice for prolapsed nictitating membrane is excision of the membrane

A

False

The membrane is important for tear production; Excision of the membrane can lead to KCS

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15
Q

What type of flap is used for tumor resection >1/3 of lid length?

A

single pedicle advancement flap

  • Used for tumor resection >1/3 of lid length
  • Make rectangular incision over mass and advance
  • Create burrows triangles to prevent dog ears
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16
Q

What is the most common neoplasia of the nictitating membrane?

A

squamous cell carcinoma (SCC)

Others include hemangiosarcoma, adenocarcinoma, and fibrosarcoma

17
Q

What forceps are typically used in ophthalmic surgery?

A

Bishop-Harmon forceps

18
Q

What enucleation approach is more commonly performed for neoplasia?

A

transpalpebral approach

  • Oppose and suture eyelid margins
  • Incision 5mm around palpebral fissure
  • Dissect along orbital walls for exenteration
  • Do not place excessive traction on optic nerve
19
Q

What are the indications for performing an enucleation?

A
  • Painful non-visual eye
  • Neoplasia and non-responsive infections
20
Q

What is acquired entropion usually associated with?

A

lid spasm

  • Corneal ulcers, KCS, foreign body
  • Normally you can treat the underlying problem to resolve
21
Q

Name two surgical options for treating prolapsed nictitating membrane:

A
  • Orbital rim anchoring technique: more technically difficult
  • Pocket technique: easier to learn
22
Q

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

A

Prolapsed Nictitating Membrane

  • Gland flips up dorsally above leading edge
  • Etiology unknown
  • Cockers, Pekingese, Bulldogs, Beagles
  • Ocular discharge and conjunctivitis
23
Q

What percentage of eyelid tumors in dogs are benign?

A

~75%

Most commonly meibomian gland adenoma

24
Q

Eversion of the eyelid is termed:

A

ectropion

  • Congenital
    • Saint Bernard
    • Bloodhound
  • Acquired
    • Contraction of scar tissue
    • Overcorrection of entropion
  • Usually only lower lid
25
Q

A Dziezye Millichamp Mucocutaneous Pedicle Graft is a reconstruction technique for eyelid agenesis.

How do you pronounce Dziezye?

A

Not. A. Clue.