1. Surgery of the EYE Flashcards
(75 cards)
1
Q
hairs growing out of the meibomian gland openings
A
Distichia
2
Q
hairs that grow from palpebral conjunctiva to contact the cornea
A
Ectopic cilia
3
Q
eyelid margin inversion
A
Entropion
4
Q
eyelid margin eversion
A
Ectropion
4
Q
an incomplete blink
A
Lagophthalmos
5
Q
eyes that are turned outward (laterally)
A
Exotropia
6
Q
Part of the eye that is drainage for tears
A
Puncta
7
Q
bacteria that grew in tears
A
Tear stains
8
Q
if used in eyelids, it can cause tissue distortion & become a hazard to cornea if it loosen or shift in position
A
stiffer sutures
(polydioxanone, nylon)
9
Q
Suture material for eyelids
A
Soft suture
* polyglactin 910 (absorbable)
* silk (non-absorbable)
10
Q
result in a decrease in HR when there is a pressure in the globe
even when it is a superficial procedure, animal is still put in anesthesia so you would be able to do the procedure properly
A
Oculocardiac reflex
11
Q
Congenital abnormalities in the eye
[ DDAE ]
A
- Dermoid cyst
- Distichiasis
- Ankyloblepharon
- Entropion
12
Q
Acquired abnormalities in the eye
[ EHK PDL ]
A
- Eye worm
- Histiocytoma
- Keratoconjunctiva sicca (KCS)
- Prolapsed gland
- Descemetocoele
- Lagophthlamos
13
Q
Suture for oculocardiac reflex
A
Polyglactin
* 10-0 (really small)
* 0.2 metric
* Vicryl (Polyglactin 910)
Anticholinergic - drugs that block and inhibit the activity of the neurotransmitter acetylcholine (ACh)
14
Q
- cyst in the eye
- Can also happen in other parts of body w/ mucous membranes
- Endoderm attached to other part of body
- Can grow hair or tarsal gland
- Need to remove it
A
Dermoid cyst
15
Q
- a double row of cilia (should be 1 only)
- 2nd abnormal line is usually directed towards cornea
- masakit sa mata
A
Distichiasis
16
Q
- closing eyelids
- common in newborns, but should open up in a few days
- if does not open on its own = needs surgical intervention
A
Ankyloblepharon
17
Q
- like effect of distichiasis
- curling of skin inwards
- hair should not touch the cornea
- hair grows inwards and brushes the cornea
- may worsen over time, so clinical disease may show up later in life
A
Entropion
18
Q
Diseases & indications of eye (5)
A
- Chronic conjunctivitis
- Weight loss
- Corneal ulceration
- Age
- Chronic entropion
- Severe ectropion
18
Q
tumorous based on the histiocytes
A
Histiocytoma
19
Q
Chronic entropion in cats can commonly lead to the formation of a ____ ____
A
corneal sequestrum
19
Q
Parasite in eyeworm that is not cured by a dewormer
Needs surgical intervention
A
Thelazia spp.
20
Q
the 3rd eyelid gland (Cherry eye)
A
Prolapsed gland
21
Q
- dry eyes
- tears are measured
- transposition of the salivary duct
- Surgery - address what caused it first
A
Keratoconjunctiva sicca (KCS)
22
bulging of the descement membrane
## Footnote
* do not cut of membrane
* let it heal by closing eyelid
Descemetocoele
23
* incomplete closure of the eyelid
* too big eyeballs
* tears won't reach pupils
* common in brachycephalic animals
* need to close by reconstruction of eyelid so it can reach lower eyelid
Surgery
* add eyelid
* incise with scalpel
* overtime it will heal bigger
Lagophthalmos
23
(3) Surgical procedure for **eyelids**
1. Canthotomy / Canthoplasty
2. Tarsorrhaphy
3. Blepharoplasty
24
(3) steps for preop for ocular surgeries
1. Flush eye
2. Rinse
3. Stay suture
24
(1) Surgical procedure for **conjunctiva**
Conjunctiva flaps
25
Preop of eye that is not used anymore
eyelid speculum
26
(1) Surgical procedure for **parotid duct**
Parotid duct transposition
27
(2) Surgical procedure for **third eyelid**
1. Third eyelid flap
2. Correction of third eyelid gland prolapse
28
(3) Surgical procedure for **globe**
1. Enucleation
2. Extirpation
3. Paracentesis oculi
29
Give the eyelid surgery:
* Palpebral fissure is made bigger by cutting to the lateral side
* Papalakihin lang yung operative field, unless the palpebral fissure is too small
* Another reason is for tears (sugat) in the eyes
Canthotomy / Canthoplasty
30
Closure for canthotomy / canthoplasty
**2-layer closure**
* Suture = buried HMSP / Horizontal mattress / SISP
* Figure of 8
or
**1-layer closure**
* usual closure
* figure of 8
* suture material would not reach inner portion of eyelid (gitna lang)
* surgical knot is placed outside, so the suture is not touching the cornea
31
to facilitate healing of the cornea
Temporary Tarsorrhaphy
32
Difference in permanent tarsorrhaphy
knot of closure
33
(2) Indications for temporary tarsorrhaphy
1. patients who cannot blink
2. traumatic proptosis
34
Suture for temporary tarsorrhaphy
3-4 horizontal mattress
35
(2) suture materials for temporary tarsorrhaphy
1. Stents
2. Cyanoacrylate glue
36
Suture for temporary tarsorrhaphy that will not cut thru skin
Stents
37
removal of eyeballs
* risk of damage to skull, brain if not closed
* closed for life
* reduces the palpebral fissure size in animals with macropalpebral fissure (large eyelid openings)
permanent tarsorrhaphy
38
closure of permanent tarsorrhaphy
split thickness suture
39
Indications for **permanent tarsorrhaphy**
1. ectropion
2. entropion
3. excessive corneal exposure
4. risk for traumatic proptosis
40
Identify the procedure.
Put in chronological order.
1) By examining the eyelid opening size relative to the horizontal corneal diameter.
2) After the tarsorrhaphy, the palpebral fissure opening should cover most of the exposed bulbar conjunctiva but should not cover the cornea.
3) Determine the amount of eyelid margin to be removed laterally
3
1
2
41
thickest layer of the eye
it takes in the dye and becomes **green**
stroma
42
Which eye anatomy is gone if the eye turned green
1. Epithelium
2. Bowman's later
43
Intact Bowman only
erosion
44
eye surgery
generally preferred in brachycephalic breeds with exotropia to reduce lagophthalmos by correcting the ventromedial entropion, as well as reducing the palpebral fissure size.
medial canthoplasty
45
Indication:
to prevent bell reflex and thus allow corneal or intraocular surgery
Immobilization of the globe
46
downward rolling of the eyeball (happens during anesthesia)
Bell reflex
47
Instruments for immobilization of the globe (3)
1. Self retaining lid retractor / stay suture
2. Fine- toothed ophthalmic forceps / rat tooth
3. Delicate needle holder
## Footnote
Material: 4-0 silk with swaged on ophthalmic cutting needle
48
Pre-op for immobilization
1. Clip
2. Flush ____ & ____ w/ sterile distilled water
3. Prepare the lids and periocular skin for aseptic surgery
**conjuctival culdesac** & **cornea**
49
(2) stay suture positions for immobilization of globe
* 10 o’clock &
* 12 o’clock positions,
## Footnote
1-2 mm from the **limbus** and engaging the **episcleral tissue**
50
fluid removal from the eye by aspirating
Paracentesis oculi
51
(4) Indications for paracentesis oculi
1. Removal of a **hyphema** from the anterior chamber
2. To relieve **intraocular pressure** in glaucoma patients
3. Removal of **organized hypopyon**
4. Recurrent **descemetocoele**
52
Identify the procedure.
Chronological order.
1. Withdraw 0.1 mL of aqueous humor
2. Insert the tip of the needle under the bulbar conjuctiva with a short, quick motion
3. Flush globe with sterile saline
4. Withdraw needle
5. Remove needle & sutures
6. The plane of the needle is parallel to the anterior surface of the iris
7. With the immobile globe, insert G-23 needle of a tuberculin syringe ~2 mm from the limbus & at an acute angle with the corneal surface (6 o’clock position)
7
1
6
5
2
4
3
52
can serve as bandages (similar to an opaque contact lens) to mechanically protect the cornea after trauma.
Third eyelid flap
53
Third eyelid flap do not function like ____ ____ because it
* provides vascularization
* metabolic and tectonic support by integrating to the cornea
conjunctival grafts
54
Identify the procedure.
Chronological order.
1. Grasp the 3rd eyelid w/ forceps & pull across the cornea
2. Place plastic tubing above the skin where the suture will be tied
3. Second entry to the upper eyelid is from the: fornix through the skin
4. Anchor and suture though the skin of the upper eyelid into the fornix
## Footnote
show teacher then remove suture
4
1
3
2
55
Do not use 3rd eyelid flaps on (3)
1. deep corneal ulcers
2. descemetoceles
3. corneal perforations
55
(2) Indications for third eyelid flap
1. bullous keratopathy
2. indolent corneal ulceration
56
it is where the corneal epithelium is not adhering well to the underlying corneal stroma
indolent corneal ulceration
57
suture pattern for temporary tarsorrhaphy
horizontal mattress
at lateral 2/3 fissures only
58
Material/s for temporary tarsorrhaphy
* stents
* cyanoacrylate glue
59
reconstruction of eyelid
Blepharoplasty
60
inward rolling of eyelids
entropion
61
outward rolling of eyelids
ectropion
62
(3) corrections of entropion
1. Lid tacking (for puppies)
2. Hotz Celsus
3. Y to V
63
(1) correction for ectropion
V to Y
64
* done without removal of facial skin
* common to recur after surgery
* also used for spastic entropion
* to provide relief from corneal irritation until the primary cause is corrected
Lid tacking
65
putting suture w/o tying knot para pwede i-adjust
“Pre-place” suture
66
Entropion in ________ , especially ____ puppies, may be treated by temporarily rolling out the eyelid margin and may eventually resolve with growth.
neonate or young animal (≤20 weeks of age)
especially shar-pei puppies
67
Identify the procedure.
Chronological order.
1. Surgical spoon used to protect eyeball
2. Incise and remove part of skin
3. Grasp eyelid and remove subcutis and some portion of muscle
2
3
1
67
This skin excision surgery may need to be combined with **palpebral fissure reduction** in some breeds.
Hotz Celsus
