Laser Surgeries + Ocular motility tests

Question 1

What are the 3 kinds of laser surgeries?

Answer 1

1) LASIK - Laser assisted in situ keratomileusis
2) PRK - Photorefractive keratectomy
3) SMILE - Small incision lenticule extraction procedure

Question 2

What are 2 non laser surgeries?

Answer 2

1) Phakic IOL - Phakic intraocular lens
2) RLE - Refractive lens exchange

Question 3

What 2 kinds of lasers are used in laser surgery?

Answer 3

Excrimer lasers
Femtosecond Lasers

Question 4

What years did health canada approve each laser surgeries ?

Answer 4

PRK - 1990
LASIK - 1994
SMILE - 2015

Question 5

Which procedures are used for myopia? (5)

Answer 5

PRK
LASIK
PHAKIC IOL
RLE
SMILE

Question 6

What procedures are used for hypermyopia? (4)

Answer 6

PRK
LASIK
RLE
PHAKIC IOL (with limitations)

Question 7

What is the difference between how the 3 laser surgeries are done?

Answer 7

PRK involves using a laser to the epithelium layer of the cornea
LASIK flips the layer of the cornea over
SMILE uses a small incision and doesn’t disturb the top layer of the cornea

Question 8

What are 3 pros to PRK?

Answer 8

No flap
Can be done on a thinner cornea
effective and safe procedure

Question 9

What are 5 cons to PRK?

Answer 9

slower healing
epithelium layer removed
delayed epithelium healing
discomfort
light sensitivity

Question 10

What are 2 pros of LASIK?

Answer 10

LASIK is quick and safe
results come quickly

Question 11

What are 3 issues with LASIK?

Answer 11

Not everyone is eligible (thinner corneas)
You may need to get LASIK done again
Issues with the flap - position/folds/debris beneath it

Question 12

What is a pro with SMILE?

Answer 12

corneal sensitivity recovered faster

Question 13

What are 2 cons with SMILE?

Answer 13

less-smooth cuts
more limited for patients

Question 14

What are 3 characteristics of Phakic IOL?

Answer 14

treats high myopia and astigmatism
procedure is reversible
2 locations for the phakic IOL - anterior/posterior chamber

Question 15

What is a pro with Phakic IOL?

Answer 15

No tissue is removed for no induced dry eye

Question 16

What is a con with Phakic IOL?

Answer 16

Anterior chamber positioned IOL are associated with corneal endothelial cell loss

Question 17

What are 3 characteristics with RLE?

Answer 17

Better for High prescriptions and people with early lenticular changes
Presbyopes requiring correction in distance, intermediate and near vision.
Prefered for patients with shallow anterior chamber or low endothelial cell count

Question 18

What are 3 pros with RLE?

Answer 18

No need for cat surgery in future
Monofocal implants are available
Larger range of IOL powers are available

Question 19

What are 3 cons with RLE?

Answer 19

Halo/Glare
loss of contrast sensisvitiy
Associated with vision threatening conditions

Question 20

What are the name of the 3 tests done to test for ocular motility?

Answer 20

Hirschberg test
Krimsky test
Cover test

Question 21

How does the Hirschberg test work?
What can it detect?

Answer 21

Using a pen light you note the corneal reflex and depending on the position depends on what kind of strabismus direction the px may have
Can detect strabismus in an infant but it is not a sensitive test

Question 22

How does the Krimsky test work?

Answer 22

Using prism over the ‘normal eye’ will determine how much the other eye is deviating and in what direction. Depending on the amount of prism needed.
It is more accurate

Question 23

How does the cover test work?

Answer 23

Reliable and easy
Cover one eye will the px is focusing ahead and the DR will note the movement in the other eye.