Surgical conditions of the eye Flashcards
role of ophthalmology nurse
- assist with consults and examinations
- phone triage
- admin treatments
- set up for procedures
- maintain equipment
medial and lateral canthus
either corner of the eye
two punctum
upper and lower of nasal lacrimal ducts
nasal lacrimal duct
one end produces tears, other end comes out into nose and mouth
limbus
where the sclera meets the cornea
conjunctiva
thin layer of loose connective tissue which lies on top of the sclera (not in corners)
iris
controls diameter of pupil
what is the lens held in place by?
zonular fibres
vitreous chamber
jelly like substance
retina
contains photoreceptor cells
choroid
behind retina, contains blood vessels
optic nerve
transports signals to brain to convert them into images
dolicephalic eye conformation
can see white of sclera medially, maybe laterally but never dorsally or ventrally
- almond shape= good conformation
equipment for ophthalmic exam
- pen torch
- direct ophthalmoscope (looks into back of eye)
- 20D condensing lens (view of retina)
- tonometer (measures eye pressure)
- fluorescein (contrast agent)
- schirmer tear test strips (lacrimal secretions)
restraint for ophthalmic exam
- seat patient at edge of table
- place one hand over back towards chest and one hand supporting under chin
- don’t squeeze neck (will raise IOP)
handling of patients with increased IOP
- no neck leads
- no jugular samples
- keep barking/stress to a min
- no temp checks
- increased venous pressure = increased IOP
ophthalmic history questions
- start broad then narrow down to presenting complaint
- signalment
- general history (vaccination, travel, other animals)
- known illness or signs of illness
- previous ocular conditions + treatment
- vision
distant and close examination
- animal’s attitude, body condition
- face: symmetry, ocular discharge
- eyelids: palpebral fissure, size, colour
- eyeballs: position, size, direction, movements
- observation of pupil: static (symmetry, size) and dynamic (pupillary light reflex)
- use of direct ophthalmoscope
neuro-ophthalmic exam (reflexes and tests of vision
- pupillary light reflex (PLR)
- dazzle reflex (should blink)
- menace response
- tracking response
- visual placing (on surface)
- maze test (in bright and dim light)
common ophthalmology tests
- Schirmer tear test (15-25mm over 1min)
- bacterial swab, cytology, culture + sensitivity
- fluorescein staining
- IOP measurement (10-25mm/Hg)
- gonioscopy (special lens for glaucoma)
- ocular ultrasound, electroretinogram
low IOP can indicate…
uveitis (inflammation in eye)
high IOP can indicate…
glaucoma
signs of ocular pain
- increased blinking (blepharospasm)
- increased lacrimation
- redness
- photophobia (painful to look at light)
- rubbing
- myosis (contraction of pupil)
- 3rd eyelid protrusion
purpose of eye lubricant
provides a protective layer, soothes dry eye
mydriatic eye lubricant
- short term pupil dilation, muscle spasm release, comfort
- tropicamide
topical antibiotics
- treatment and prevention of bacterial infection
topical NSAIDs
- treatment of inflammation within the eye
carbonic anhydrase inhibitor
- reduce IOP (glaucoma), decrease production of aqueous humour
prostaglandin analogue
- increase aqueous outflow
OS definition
ocular sinister (left eye)
OD definition
ocular dexter (right eye)
OU definition
ocular uterque (both eyes)
ocular prep for eyelid surgery
- clip good margins around the eyelid
- always use povidone iodine solution not scrub or tincture
- 1:10 parts for eyelid (iodine + saline)
- 1:50 parts for globe
prep for eyelid surgery steps
- wear gloves
- apply lots of lubricating gel to eyes
- clip area without causing irritation
- use gauze and sterile saline to remove gel and hair from eyes
- prep globe first (1:50)
- then prep eyelids (1:10)
- after 3 mins, flush globe with sterile saline to prevent corneal toxicity
exophthalmos
abnormal protrusion of the eyeball
- due to an orbital foreign body
entropion
eyelids inverted
- hairy skin rubs on cornea
keratoconjunctivitis sicca (KCS)
dry eye
- assess tear production via schirmer tear test
- topical medication to treat (lubricants)
