Transcript Ophthalmic Surgery

Ophthalmic Surgery
Chapter 16
Anatomy of the Eye
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Sensory organ of sight
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Main function is to convert
environmental light energy to
bioelectrical energy
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Relays bioelectrical information
to the brain
Anatomy
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Orbit of the eye (7 Bones)
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Frontal, Sphenoid, Ethmoid,
Maxillary, Zygomatic, Lacrimal,
and Palate.
Anatomy
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Extrinic Muscles
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Six muscles attached from the
orbit bones move the eye in
various directions.
Superior rectus
 Inferior rectus
 Medial rectus
 Lateral rectus
 Superior oblique
 Inferior oblique
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Anatomy
Anatomy
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Lacrimal System
Lacrimal gland
 Lacrimal canals
 Lacrimal sac
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Anatomy
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Lacrimal Gland
Almond sized gland located within
the upper eyelid.
 Secretes tears to keep the
conjunctiva and the surface of the
eye moist.
 6-12 ducts exit the gland and are
arranged in a row to disperse the
secretion over the surface of the
eye.
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Anatomy
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Globe
Conjunctiva
 Sclera and cornea
 Choroid
 Ciliary body
 Iris
 Retina
 Crystalline lens
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Anatomy
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Conjunctiva
Mucous membrane covering the
eye and lining the inner surface of
the eyelid.
 Opaque and highly vascular
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Anatomy
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Sclera
Opaque white portion of the eye.
 Comprises 5/6 of the eye
maintaining the form of the globe.
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Cornea
Transparent portion of the eye.
 Anterior 1/6 of the eye.
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Together these structures form
the external tunic of the eye.
Anatomy
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Choroid
Thin, dark brown, highly vascular
membrane.
 Firmly attached to the sclera.
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Ciliary Body
Similar in structure to the choroid,
but has larger blood vessels.
 Ciliary (Intrinsic) Muscle
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Ring muscle
Anatomy
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Iris
Meaning “rainbow” it is the various
colored portion of the eye.
 Continuous with the ciliary body
 Perforation in the center called the
pupil allows for the transmission of
light.
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Choroid, Ciliary Body, and the
Iris make up the middle tunic of
the globe.
Anatomy
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Retina
Delicate nervous membrane on
which images are received.
 Continuous with the optic nerve.
 Center of posterior eye is a
structure known as the macula.
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Anatomy
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Crystalline Lens
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Transparent, biconvex body
situated behind the pupil, in front
of the vitreous body.
Cavities and
Chambers of the Eye
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Anterior Cavity
Lies in front of the lens
 Two chambers
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Anterior chamber is anterior to the
iris, but posterior to the cornea
 Posterior chamber is posterior to the
iris, but anterior to the lens.
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Filled with watery fluid called
aqueous humor.
Cavities and
Chambers of the Eye
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Posterior Cavity
Larger than the anterior cavity
 Area posterior to the lens,
suspensory ligaments, and ciliary
body.
 Filled with soft gelatin substance
called vitreous humor.
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Maintains pressure to keep eyeball
from collapsing.
Anatomy of the Eye
Anatomy of the Eye
Anatomy of the Eye
Surgical Pathology
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Glaucoma
Cataract
Small/large retinal detachment
Chalazion
Strabismus
Ophthalmic Medications
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Mydriatics
Cause pupil dilation by paralyzing
the iris.
 Atropine sulfate, Neo-Synephrine.
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Miotics
Cause the pupil to constrict.
 Pilocarpine HCL
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Ophthalmic Medications
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Viscoelastic Agents
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Used to expand the anterior
chamber during cataract surgery.
Anti-inflammatory Steriods
Suppresses the inflammatory
response in the eye.
 Prednisolone
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Ophthalmic Medications
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Lubricants
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Local Anesthetics
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Protects the cornea from drying
out when the eye is unable to
close.
Tetracaine
Retrobulbar Anesthesia
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Injecting lidocaine or marcaine
around the optic nerve.
Ophthalmic Medications
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BSS
Balanced Salt Solution
 Used during eye surgery to keep
the cornea from drying out.
 STSR will typically irrigate.
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Supplies and Instruments
Scleral Depressor
Castro Viejo N/D
Muscle Hook
Supplies and Instruments
Colibri Forceps
Bishop Harmon Forceps
Supplies and Instruments
Phaco Emulsifier
Operating Microscope
Common Procedures
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Strabismus CorrectionRecession
Scleral Buckle
Enuleation
Cataract extraction
Common Procedures
Common Procedures
Common Procedures
Special Considerations
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Patient under
local
anesthesia
Room must be
quiet
More
specialized
equipment
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Personal use
instrumentation
Smaller suture
and needles
Microscope
Ophthalmic
medications
Ophthalmic Surgery
 QUESTIONS?