Download Welcome to Main Theatres – Ophthalmology

Welcome
to
Main Theatres
Ophthalmology
Added to NU Placements Website May 2011
Welcome to Main Theatres – Ophthalmology
We hope you enjoy your placement in the department
and benefit from your experience. We aim to provide a
learning environment that is challenging and enables
students to fulfil outcomes set by the university. A
mentor is allocated to each student to guide you
through your learning outcomes and will regularly
review your progress. Please don’t hesitate to provide
any feedback or concerns you may have regarding your
placement.
Department Profile
Our department consists of two operating theatres
which cater for both in-patient and day case surgery.
Both theatres operate Monday to Friday from around
8:30 am to 5:30 pm. All types of ophthalmic surgery
are performed within the department including :-
vitreo-retinal surgery
paediatric ophthalmic surgery
strabismus (squint) surgery
lid surgery
corneal surgery
cataract surgery
oncology surgery
emergency surgery e.g. penetrating injury , lid
laceration
Added to NU Placements Website May 2011
PHILOSOPHY OF CARE
We believe each individual should receive a holistic
approach to care which accounts for physical,
psychological and cultural needs.
Care should be offered in a clean, safe environment
and delivered in a courteous, professional manner.
Confidentiality, privacy and dignity should be respected
at all times through practice within the professional
code of conduct.
We aim to improve patient care through life-long
learning, audit and evidence based practice and so
offer patients informed choices in their care.
Each patient will have his or her own Named Nurse
responsible for assessing, implementing and coordinating care within the multi-disciplinary team.
By use of a problem solving, patient focused approach
to care, we hope to build a partnership of care that
aims to help patients attain, maintain and restore
health.
We aim to develop our role as educators and provide a
supportive environment where learning is encouraged
for all staff, patients and carers.
Added to NU Placements Website May 2011
There are 11 different consultant ophthalmologists who
operate regularly in our department and their
specialities include :
-
Vitreo-retinal surgery
Corneal surgery
Eyelid and plastic surgery
Paediatric ophthalmic surgery
Strabismus (squint) surgery
Glaucoma surgery
Ophthalmic oncology surgery
There are other surgeons who specialise in fast track
cataract surgery.
These surgeons are based in Cataract Treatment
Centre and only operate in our theatres on emergency
cases.
Added to NU Placements Website May 2011
Most patients operated on within the department are
in-patients from Haygarth Ward and usually require a
general anaesthetic. We also perform day case surgery
under local anaesthetic, usually for patients requiring
lid surgery e.g. for an in-turning eyelid (entropian).
Some of our staff have an ophthalmic nursing
qualification and training for those who don’t is
encouraged when opportunities arise.
Research is also encouraged from both nursing and
medical staff to improve and update current practice.
Primary Nursing
Patients visiting theatre from Haygarth ward are
allocated their own primary nurse on arrival. This nurse
will then be responsible for the patients care during
their entire stay in the department. The same method
is adopted for patients attending the department as
day case patients.
Each consultant is also allocated their own primary
nurse who is responsible for co-ordinating the care and
nursing team when they operate in the department.
The consultant also liases directly with their primary
nurse to ensure all requests , equipment etc are
satisfied.
Added to NU Placements Website May 2011
MAIN THEATRE : Nursing Staff
There is one department manager (band 7) and one
junior sister (band 6)
The are also 12 band 5 staff nurses mainly full time
with various levels of experience and qualifications.
There are currently 2 theatre support workers (health
care assistants.
The department also employs one full time Operating
Department Practitioner (ODP) who mainly works with
the anaesthetic staff.
Theatre Sterile Supplies Unit
Attached to the Theatre Department is a sterile
supplies department.
All equipment requiring sterilisation is pre-washed on
site then sent to TSSU at Sunderland Royal Hospital
for Autoclaving. All equipment on return is checked and
either stored in the department or distributed to the
departments throughput the hospital
-
Theatres
Cataract Treatment Centre
Casualty and Outpatient Departments
Haygarth Ward
Excimer Unit
Diagnostic Unit
Added to NU Placements Website May 2011
Theatre Timetable 2010
Monday
Am Th. 1
Th. 2
Monday
Pm Th. 1
Th. 2
Tuesday
Am Th. 1
Th. 2
Tuesday
Pm Th. 1
Th. 2
Wednesday Am Th. 1
Th. 2
Wednesday Pm Th. 1
Th. 2
Thursday
Am Th. 1
Th. 2
Thursday
Pm Th. 1
Th. 2
Friday
Am Th. 1
Th. 2
Friday
Pm Th. 1
Th. 2
Added to NU Placements Website May 2011
Mr Tiffin
Mr Morgan
Mr Fraser
Vitreo-retinal
Mr Steel
Miss Chapman
Mr Wride
Mr Boyce
Mr Inglesby
Mr Allchin
Mr Steel
Mr Allchin
Mr Steel
Mr Gnanaraj
Mr Boyce
Mr Morgan
Mr Inglesby
Mr Osborne
Miss Chapman
Mr Osborne
Paediatrics
Corneal/Mix
Cataract/Glaucoma
Emergency List
Vitreo-retinal
Lids/Plastics
Cataract/Glaucoma
Lids/Plastics
Vitreo-retinal
Strabismus
Vitreo-retinal
Strabismus
Macular
Paediatric/Mix
Lids/Plastics
Corneal/mix
Vitreo-retinal
Lids/Plastics
Lids/Plastics
Lids/Plastics
Hours of Duty
Full time staff are required to work Monday to Friday
and do three 8 – 5:30 shifts and two half days. Start
and finish times are flexible when necessary either
staff or the department. Normal shift times are as
follows :
- full day, 08:00 til 17:30
- half day, 0800 til 13:00 or 13:30
- reverse half day, 12:30 til 17:30
As we are a Monday to Friday area only, there are
usually no difficulties in working your minimum of 50%
of shifts with your mentor.
If you are off sick at any time, remember to inform
both us and your university.
There are also always two members of staff on-call for
out of hours emergency cases.
Useful Telephone numbers
Office Extension
49156
Direct Line
0191 569 9156
Line Extension
46280
Coffee Room
46283
Sister’s Office
46295
Added to NU Placements Website May 2011
Emergency Alarm Calls And Numbers
Fire Alarm
Every Thursday morning the fire alarm sounds an
intermittent tone at around 11:45 am. This is the test
procedure. If this sounds at any other time it indicates
a real fire alarm and action must be taken. All doors
and windows are to be closed and remain so until the all
clear is given. A continuous tone indicates a fire alarm
in your area and immediate investigation is required
and possible evacuation of all patients, relatives and
staff.
Crash Call
In the event of a cardiac arrest in the department the
first action is to put out a crash call and shout for
assistance. The crash trolley is located in the recovery
area of theatres.
Cardiac Arrest
:
2222
Fire
:
333
Security
:
777
Added to NU Placements Website May 2011
Ophthalmology
Definition
The study of the eye and its associated parts.
Ophthalmology deals with diseases of the eye and their
treatment. The word ophthalmology has greek roots
derived from the greek words ophthalmos meaning eye
and logos meaning science. So its literal meaning is ‘the
science of eyes’.
Anatomy of the Eye
Ophalmology is constantly changing and updating as
research and technology offer continually improving
treatments and equipment.
During your placement you will have the opportunity to
observe a wide variety of ophthalmic surgery in our
department. The following is a brief introduction to
the types of surgery performed in this department.
Added to NU Placements Website May 2011
Cataract
A cataract is a misting or opacity of the lens. It
prevents light entering the eye properly and causes
dimness of vision and eventually blindness if left
untreated. Most cataracts are caused by the body’s
normal ageing process but occasionally are caused by
trauma, diabetes or drugs.The cataract can be removed
by an operation called phacoemulsification (see below).
The lens is broken down using ultrasonic vibrations
then aspirated. A plastic lens implanted inside the eye
(IOL - intra ocular lens) then replaces the cataract
(see below).
Added to NU Placements Website May 2011
Sutures are not usually needed and the patient can
return to a normal lifestyle immediately afterwards.
Trabeculectomy
Indicated for patients with glaucoma. The operation is
performed where prophylactic treatment fails to
control the intra ocular pressure (IOP). The aqueous
fluid of the anterior chamber, in the front part of the
eye, is unable to drain sufficiently away due to a
blockage in the drainage channel, the trabecular
meshwork, located at the junction between the sclera
and the cornea.
Trabeculectomy involves creating a thin scleral flap and
internally cutting two small holes, one in the iris (an
iridectomy) and the other in the drainage channel,
usually at 12 o’clock to be less noticeable under the eye
lid. This allows the aqueous fluid to flow freely and
gradually be absorbed by the bloodstream and so
lowering the intra ocular pressure.
Added to NU Placements Website May 2011
Lid Surgery
Ptosis
A ptosis is a drooping of the upper lid. It can be caused
by: - Abnormal weight on the lid due to oedema, tumour
or scarring
- trauma or disease to the muscle
- paralysis of nerves supplying the upper lid
- congenital causes
A ptosis can be corrected by lid surgery during which
the levator muscle in the lid is resected.
Entropian
Is a turning in over of the eyelid due to weakness of
the lid retractors (the muscles which open and close
the eyelids). Usually occurs in the lower eye id causing
eye to water and eyelashes to rub against the cornea
causing pain and discomfort. There are many different
operations to correct entropian but all usually involve
removing part of the eyelid therefore tightening the
retractor muscle and shortening the lid.
Ectropian
Is a turning out over of the eyelid due to a weakness of
the orbicularis muscle. Usually occurs in the lower eye
lid and causes the eye to water constantly because the
drainage hole (punctum) is not in the correct position.
Added to NU Placements Website May 2011
The most common operation is to shorten the eyelid
and to enlarge the punctum to reduce watering.
Lid Lesions - Removal
Usually performed to remove a lesion for diagnostic
purposes. If results indicate a carcinoma further
surgery will be required to remove it and re-construct
the eyelid. Some lid lesions may also be removed for
cosmetic reasons.
Chalazion
The Meibomian glands are found in the eyelids and
produce a sebaceous substance, which creates the oily
layer of the tear film. A chalazion occurs when one of
the Meibomian glands swell due to a blockage of its
duct.
If the swelling does not subside the chalazion can be
removed by incision and curettage. A clamp is placed on
around the chalazion and the eyelid everted. A small
incision is made and the contents scooped out using a
curette. The clamp is then removed and some antibiotic ointment and a firm pad are applied.
Evisceration
Removal of the contents of the eye, usually after an
infection has left the eye blind. A small amount of eye
Added to NU Placements Website May 2011
movement is retained after this surgery giving a more
cosmetically pleasing result.
Enucleation
Removal of the whole eyeball leaving the extra ocular
muscles. The socket is fitted with a conformer to
enable a good cosmetic result with a prosthesis (fitted
at a later date). It is often performed as a last stage
of treatment for a painful, blind eye following
malignant melanoma.
Dacryocystorhinostomy (DCR)
Epiphora, or watery eyes, occurs because of a blockage
in the normal lacrimal drainage system, which impairs
normal tear channelling into the nasal cavity.
Recurrent infection or dacryocystitis may occur as a
result of stagnation. DCR may alleviate symptoms and
Added to NU Placements Website May 2011
involves surgical creation of a new passage of drainage
for tears into the nasal cavity.
Added to NU Placements Website May 2011
Vitrectomy and Detachment Surgery
These operations are performed for patients who have
problems with their retina often associated with
diabetes, short-sightedness (myopia) or trauma. The
operations are often intricate and lengthy procedures.
Vitrectomy (internal approach) involves removing the
jelly part of the eye (vitreous) and replacing it with a
fluid containing minerals and salts and is about the
same consistency as the aqueous fluid of the anterior
chamber. Microsurgery is then performed to attempt
to rectify the specific problem such as retinal holes,
tears or membranes.
Added to NU Placements Website May 2011
Detachment (external approach) is performed on the
outside of the eye (sclera) and involves suturing a
silicone explant onto the sclera to create an
indentation of the detached area of retina. A freezing
process (cryotherapy) is then applied over the sclera
to induce an inflammation over the retinal problem. The
inflammation will gradually subside taking the retina
back to its normal position and up against the
indentation of the explant.
Added to NU Placements Website May 2011
Occasionally a gas bubble is (SF6 or C3F8) mixed with
filtered air is injected into the eye to tamponade
problem retinal areas. The gas bubble will expand a
little inside the eye and push up against the retina and
help keep it in place. The gas bubble is gradually
absorbed. Patients may need to posture postoperatively to help with the success of the operation
i.e. lie in a certain position so gas bubble tamponades
the right area of retina. The posturing can be said to
be as important as the surgery itself.
Corneal Graft
A corneal graft is a transplant operation involving
removal of the central part of the cornea and its
replacement with a cornea from a donor. The donor
cornea comes from someone has expressed a wish that
their corneas be used to help someone else see after
their death. The donor cornea is sutured to the host
using either a series of interrupted sutures or one
continuous suture. The sutures may be left in place for
up to two years. Although rare, corneal rejection is a
post op complication and can occur even years after
surgery. Rejection occurs most commonly in the first
year after surgery.
Added to NU Placements Website May 2011
LEARNING ZONES
Pre-admission Assessment Clinic
Almost all elected patients are assessed prior to
admission within one month of their surgery date,
investigations
are
undertaken,
eg
tonometry,
venepuncture, electrocardiograph, focimetry. Physical
and social needs are taken into consideration and social
services, occupational therapists or district nurses may
be required for input on discharge from hospital.
These services can be organised before admission,.
The patient can receive information about their
forthcoming surgery here.
Haygarth Clinic
Specialised nurse-led clinics are undertaken here, eg
blood monitoring, oculoplastics.
Patients
attend
as
outpatients.
Consultant
Ophthalmologists also hold regular clinics here.
Cataract Treatment Centre
Patients are assessed prior to day case surgery, nurses
prepare the patient for surgery and surgery such as
cataracts under local anaesthetic and other eye
operations are carried out and the patient is usually
discharged the same day.
Added to NU Placements Website May 2011
Nurses carry out a post-operative telephone
assessment on the first post-operative day.
Patients are also seen as outpatients by Consultants
and listed for surgery as well as reviewed one-two
weeks post-operatively.
Main Theatre / Day Case Unit
Again, patients are assessed prior to day case surgery.
Patients undergo surgery for all manner of eye
problems under general and local anaesthetic, eg
vitrectomy, squints, cataracts, trabeculectomies.
Nurses carry out a post-operative telephone
assessment on the first post-operative day.
Accident and Emergency
Patients attending the department are triaged into one
of three categories.
1 = ocular emergency
2 = urgent
3 = non-urgent
The patient will be seen by the nurse practitioner, the
nurse consultant, or the doctor, who can carry out the
ocular examination and treatment.
Conditions can
include chemical injury, embedded corneal foreign
body, arc eyes, eyelid lacerations, penetrating injuries,
conjunctivitis etc. A minor operating theatre exists
Added to NU Placements Website May 2011
for small repairs/excision of chalazions and injection
of botulinum toxin injections.
Diagnostic Unit
Ocular ultrasound is undertaken, as well as laser
treatment and fluorescein angiograms on in-patients
and out-patients as needed.
Medical physics investigations can be done also.
The glaucoma unit also carries out tests here
Excimer Laser Unit
Patients undergo refractive surgery here carried out
by the Corneal Consultants.
Out-patients
Visual acuity is checked at each visit and doctor in the
clinic sees the patient. Adult and paediatric clinics are
held here.
Orthoptic Department - Orthoptists measure for
straight eyes.
Pharmacy
Dispensing of in and out patient prescriptions.
Opportunity to observe the working of the pharmacy
department and the various types of medications
available.
Added to NU Placements Website May 2011
Profile of Learning Opportunities
Learning Opportunity
Use
-
Of Telephone
making calls
answering calls
ring back facility
awareness who to
report to
- bleep system
Resource / Relevant
Personel / Department
Theatre Nursing Staff
Using HISS / Computers
- patient admission
profiles / information Theatre Nursing Staff
- order entry
- retrieve results
- internet
Library Staff
- email access
Participation
- patient care
- MDT
Patient Care
- prioritising patient
needs
- different methods of
care delivery e.g.
Added to NU Placements Website May 2011
Nursing and medical staff
MDT members
-
-
-
-
primary nursing,
named nursing,
nursing caseload
observation skills e.g.
BP, temeperature,
pulse, ECG, blood
glucose, INR,
urinalysis
accurate
documentation e.g.
early warning scores,
theatre register
instillation eyedrops
A-scanning
IOP measurement
Scrubbing for
ophthalmic surgery
Circulating (floor)
nurse
Recovery of patients
including airway
management,
monitoring oxygen
saturation,
administration of
oxygen, IV therapy
Pain relief
Infection Control
- policies
- source and spread of
Added to NU Placements Website May 2011
Theatre Nursing Staff
Anaesthetist
Medical Staff
ODP’s
Theatre Nursing Staff
Infection Control
infection
- aseptic technique
- appropriate
equipment,clothing
Oncology
- epidemiology /
aetiology
- treatment
- surgery – radioactive
plaque
- isolation nursing
Ophthalmology
- anatomy of eye
- diseases e.g.cataract
- treatment
- surgery
- ophthalmic pharmacy
- pre-assessment
- oculoplastics
- nurse led post op
clinics
- nurse led glaucoma
clinics
- outreach clinics
Health Promotion
- patient education
- health promotion
literature
Added to NU Placements Website May 2011
Department
Infection control link
nurse
Theatre Nursing Staff
Ward Nursing Staff
Ophthalmic Oncology
Specialist – Mr Wood
Eye Infirmary Nursing
Staff
Learning Zones e.g. CTC,
Haygarth, OPD, A+E
Medical Staff
Pharmacist
Outpatient B : preassessment
All Nursing and Medical
Staff
Smoking Cessation Advisor
- smoking cessation
- low visual aids
Communication Skills
- assessment /
discussion / education
patients and relatives
- interviewing /
questioning skills
during assessment
LVA unit
Theatre Nursing Staff
Pre-assessment Nursing
Staff in CTC and Haygarth
Ward
Managing care
- nursing process
- philosophy of care
- admission day case
patients
- assessment e.g. who
assesses, how, what
and where
Nursing Staff
- planning of care
- computerised care
plans
- implementation of
care
- evaluation of care
- discharge patients
- referrals to members
MDT
- risk assessment tools
e.g. EWS
Added to NU Placements Website May 2011
GLOSSARY OF OPHTHALMIC TERMS
Abduction
Acanthamoeba
Accommodation
Adduction
Amblyopia
Alpha, Gamma and Kappa
Aniridia
Aphakia
Applanation tonometry
Arcus senilis
Argon laser
Added to NU Placements Website May 2011
Turning the eye outwards.
A genus of free-living
amoeba.
The ability of the lens to
change shape to allow near
objects to be focused on
the retina.
Turning the eye inwards.
Reduced vision usually due
to interference with the
eye’s development.
Different angles in the
eye measured between
the optic axis and the
visual axis.
Absence of the iris.
Absence of the lens.
Measurement of the
intra-ocular pressure by
flattening the cornea.
Degenerative change in
the cornea resulting in a
white ring around the
corneal circumference.
Laser that uses
photocoagulation.
Astigmatism
Uneven curvature of the
cornea.
Binocular vision
Co-ordinated use of both
eyes resulting in a single
vision.
Measurement of the axial
length of the eye.
Inflammation of the lid
margin.
Painful involuntary spasm
of the eyelids.
Optic disc where there
are no nerve endings, only
nerve fibres.
Oedema of the cornea
causing ‘blister’ formation
in the epithelium.
Outer and inner areas
where the upper and lower
lids meet.
Opening of the capsule of
the lens.
Plastic shield to protect
the eye.
Small fleshy area in inner
corner of the eye.
Opacity of the lens.
Area of vision when
looking straight ahead.
Biometry
Blepharitis
Blepharospasm
Blind spot
Bullous keratopathy
Canthus
Capsulotomy
Cartella shield
Caruncle
Cataract
Central field/vision
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Chalazion
Chemosis
Chlamydia
Commotio retinae
Concave lens
Concretion
Convex lens
Cycloplegia
Cylindrical lens
Dacryoadenitis
Dacryocystitis
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Meibomian gland cyst.
Internal hordeolum.
Oedema of the
conjunctiva.
Chronic conjunctivitis
caused by serotypes D-K
of Chlamydia trachomatis.
Oedema of the retina
following trauma.
A lens which diverges
light rays, used to correct
myopia: a ‘minus’ lens.
Lipid deposit in the
conjunctiva.
A lens which converges
light rays, used to correct
hypermetropia: a ‘plus’
lens.
Paralysis of the ciliary
muscles.
A lens of cylindrical
shape, which refracts
light rays in various
directions in different
meridians, used to correct
astigmatism.
Inflammation of the
lacrimal gland.
Inflammation of the
lacrimal sac.
Dacryocystorhinostomy
Dendritic ulcer
Descemetocele
Dioptre
Diplopia
Disciform keratitis
Distichiases
Drusen
Ectropion
Electroretinogram
Emmetropia
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An operation to make a
passage from the lacrimal
sac into the nose to
overcome obstruction.
A branching ulcer of the
cornea caused by the
herpes simplex virus.
Protrusion of Descemet’s
membrane through the
stroma and epithelium of
the cornea.
Unit of measurement of
strength of the refractive
power of the eye, or
lenses, expressed as a
fraction of a metre.
Double vision.
Inflammation of the
cornea as a complication
of herpes simplex virus.
Double row of eyelashes.
Small yellow nodule in
Bruch’s membrane or optic
nerve.
Turning out of the eyelid.
A recording of electrical
activity of the retina.
Absence of refractive
error.
Endophthalmitis
Endophthalmos
Entropion
Enucleation
Epicanthus
Epilation
Epiphora
Episcleritis
Evisceration
Excimer laser
Exenteration
Exophthalmometer
Exophthalmos
Added to NU Placements Website May 2011
Inflammation/infection of
inner structures of the
eye.
Displacement of the
eyeball downwards.
Turning inwards of the lid
margin.
Removal of eyeball and
length of optic nerve.
Broad fold of skin in inner
canthus.
Removal of an eyelash.
Watering eye.
Inflammation of the
episcleral vessels.
Removal of the contents
of the eyeball, leaving the
sclera intact.
Laser used for corneal
surgery, eg for correcting
refractive errors or
removing corneal scars.
Removal of the contents
of the orbit, including the
eyeball and lids.
Instrument for measuring
the degree of protrusion
of an eye.
Protrusion of one or both
eyes - usually refers to
Field of vision
Fields of gaze
Fixation
Floaters
Fundus
Fusion
Glaucoma
Gonioscope
Guttae (G.)
Hemianopia
Heterochromia
Added to NU Placements Website May 2011
that caused by thyroid
eye disease.
The entire area that can
be seen without moving
the eye.
The different areas that
can be seen when moving
the eye in all directions.
The eyes are fixed on an
object centrally at a
chosen distance.
Small, dark particles in
the vitreous.
Posterior aspect of the
retina including the optic
disc and the macula.
Co-ordinating the images
seen by both eyes into a
single image.
Increased intra-ocular
pressure sufficient to
damage vision.
A contact lens mirror used
to view the anterior
chamber angle.
Eyedrops.
Half-vision - unilateral or
bilateral.
Difference coloured irises
in one person.
Hordeolum
- internal
See
Chalzion
- external
See Stye
Hypermetropia
Long sight.
Hyphaema
Blood in the anterior
chamber.
Hypopyon
Pus in the anterior
chamber.
Injection
Degree of redness of the
conjunctiva.
Interpupillary distance(IPD) The distance between the
two pupils.
Interstitial keratitis
Inflammation of the
cornea due to syphilis.
Iridectomy
Removal of a piece of the
iris.
Iridodyalysis
Severance of the iris
from the ciliary body.
Iridodonesis
Quivering of iris following
intra-capsular cataract
extraction.
Iridotomy
A hole in the iris, usually
performed by the laser
beam.
Iris bombe
Bulging forward of the
iris.
Iris prolapse
A section of the iris
prolapsing through a
wound, either surgical or
traumatic.
Iritis
Inflammation of the iris.
Added to NU Placements Website May 2011
Ishihara colour plates
Keratitic precipitates
Keratitis
Keratoconus
Keratometer
Lacrimation
Lagophthalmos
Lamellar graft
Laser
Microphthalmos
Miotic
Mydriatic
Myopia
Oculentum (Oc.)
Operculum
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Multi-coloured charts for
testing colour vision.
Plaques of protein
adhered to the corneal
endothelium in uveitis.
Inflammation of the
cornea.
Conical-shaped deformity
of the cornea.
Instrument for measuring
the curvature of the
cornea.
Production of tears.
Incomplete closure of the
eyelids.
Partial thickness corneal
graft.
Light Amplification by
Stimulated Emission of
Radiation. Energy
transmitted as heat.
Small eyeball.
Drug that constricts the
pupil.
Drug that dilates the
pupil.
Short sight.
Eye ointment.
A semi-circular tear in the
retina, covered with a flap
of retina.
Ophthalmia neonatorum
Ophthalmoplegia
Ophthalmoscope
Optic axis
Palpebral
Pannus
Panophthalmitis
Penetrating graft
Perimeter
Peripheral vision/field
Phacoemulsification
Phasing
Phlyctenule
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Severe conjunctivitis of
the newborn.
Paralysis of the extraocular muscles.
Instrument for examining
the retina.
The line through the
centre of the optical
structures of the eye.
Pertaining to the eyelids.
Neovascularisation of the
cornea.
Inflammation of the whole
eyeball.
Full-thickness corneal
graft.
Instrument for measuring
the field of vision.
Area of vision outside
central field of vision.
Removal of a cataract by
ultrasound, breaking down
lens matter prior to it
being aspirated.
Regular frequent
measurements of intraocular pressure over a few
days.
Small vesicle of allergic
origin on limbal area of
conjunctiva and/or cornea.
Photophobia
Photopsia
Phthsis bulbi
Pinguecula
Placido’s disc
Presbyopia
Preseptal callulitis
Prism
Proptosis
Pterygium
Ptosis
Refraction
Refractive surgery
Added to NU Placements Website May 2011
Sensitivity to light.
Sensation of flashing
lights.
Shrunken eyeball.
A yellowish overgrowth of
conjunctiva.
A disc with alternating
black and white rings for
reflecting onto the cornea
to detect any irregularity
in its curvature.
Inability to focus for near
sight due to hardening of
the lens nucleus after the
age of 40 years.
Inflammation of preseptal
portion of the eyelids.
A triangular-shaped lens
used to correct diplopia.
Protrusion of the eyeball.
A triangular proliferation
of conjunctival tissue that
can invade the cornea.
Drooping eyelid.
(1) Bending of light rays.
(2) Measurement of and
correction of refractive
errors of the eye.
Corneal surgery to correct
refractive errors.
Retinal detachment
Separation of the
epithelial layer of the
retina from its neural
layers.
Retinitis pigmentosa
An hereditary
degeneration of the
retina.
Retinoblastoma
Highly malignant tumour
of the retina in infancy.
Retinopathy
Non-inflammatory disease
of the retina.
Retinopathy of prematurity A vasoproliferative
retinopathy occurring in
premature infants.
Retinoscope
Instrument for objective
assessment of refractive
errors.
Retrobulbar
Behind the eyeball.
Retropunctal cautery
Cautery applied behind
the punctum to cause
fibrosis and inturning of
the lower lid.
Rhodopsin
Light-sensitive pigment of
the rods in the retina ‘visual purple’.
Rodding of fornices
Passing a glass rod in
either fornix.
Rubeosis irides
Neovascularisation of the
iris.
Scleritis
Inflammation of the
sclera.
Added to NU Placements Website May 2011
Scleromalacia
Degeneration of the
sclera.
Scotoma
An area of visual loss in
the visual field.
Seidel test
A test to ascertain
leakage of aqueous
through a section or
perforative wound using
fluorescein drops.
Sjorgen’s syndrome
Syndrome comprising
arthritis, dry eyes,
dysphagia and
achlorhydria.
Snellen chart
A chart consisting of
graded letters, symbols or
numbers for testing
central vision.
Squint
Strabismus - deviation of
one eye.
Staphyloma
A protrusion of the
cornea or sclera.
Stereopsis
Perception of depth with
binocular vision.
Stevens-Johnson syndrome Acute mucocutaneous
vesiculobullous disease.
Strabismus
See Squint.
Stye
Inflammation of one lash
follicle. External
hordeolum
Superficial punctuate keratitis Superficial spots of
inflammation of the
Added to NU Placements Website May 2011
Symblephron
Sympathetic ophthalmitis
Synaechiae
Tarsorrhaphy
Tear film
Tenon’s capsule
Tomography
Tonometer
Topography
Toric contact lens
Trachoma
Added to NU Placements Website May 2011
cornea which stain with
G.fluorescein.
Adhesion of the bulbar
and palpebral conjunctiva.
Severe uveitis in one eye
following trauma involved
the uvea of the other eye.
Adhesion of the iris (a) to
the lens - posterior
synaechiae; (b) to the
cornea - anterior
synaechiae.
Suturing together of the
eyelids.
The film of liquid covering
the eyeball.
Membrane encircling globe
from limbus to optic nerve
overlying the sclera.
Computerised scan of the
optic disc.
Instrument for measuring
intra-ocular pressure.
A contour map of the
curvature of the cornea.
Contact lens to correct
astigmatism.
Potentially blinding
infection of the
conjunctiva and cornea
caused by the TRIC virus.
Trichiasis
Uveitis
Visual acuity
Visual axis
Visual field
Vitrectomy
Xanthelasma
Xerophthalmia
Yag laser
Added to NU Placements Website May 2011
Ingrowing or inturning of
eyelashes.
Inflammation of the uveal
tract.
Detailed central vision.
The line between a point
viewed and the macula.
Area of vision.
Removal of vitreous.
Fatty deposits on the
eyelids.
Lack of vitamin A
resulting in corneal and
conjunctival disease.
Laser that cuts holes in
structures.
Main Theatre / Day Case Unit
Ophthalmology
Placement Evaluation Form
Date of placement :_____________________
Mentor Name
:_______________________
1. Were you allocated a mentor on arrival to the
department ?
2. Were you orientated to the area ?
3. Did you work at least 50% of your shifts with your
mentor ?
4. Did you feel adequately supported during your
placement ?
Added to NU Placements Website May 2011
5. Did you achieve the competencies required by the
university ?
6. Did you access any of the learning zones during your
placement ?
7. If not , can you explain why not ?
8. Was the portfolio of learning opportunities helpful ?
9. Do you feel the placement has taught you any new
skills ?
10. How could we have improved your placement ?
Added to NU Placements Website May 2011
Student Induction Checklist (Ward and Department Areas)
Student
Name…………………………………………………………………………………………………….
Mentor
Name...........................................................................................................................................
Ward/Department.......................................................................................................................
.............
This document is to ensure that the students accessing your ward/department are inducted and orientated
appropriately- within the first week of placement. This is an NMC requirement for student support and learning in
practice (NMC, 2008).
Students must be allocated a trained and updated mentor and must work a minimum of 50% of the time in placement
with their mentor. This is necessary in order to meet the NMC requirements and to achieve a continuous and
comprehensive assessment of the student. The student’s off duty should be recorded alongside their mentor’s shifts.
Please take the level/year/experience of your student into consideration when discussing some of the topics listed
(eg. first yr, first placement student will only require a very basic awareness about some of the identified topics)
Please complete this form and retain a copy within the Evidence File (the student should also retain a copy as
evidence of achievement.
Initial Interview



Issue POLO document or advised to access via NU website
Discuss student responsibilities while on placement
Discuss strategy to achieve learning outcomes & schedule
to review progress
Ward Orientation
 Introduction to ward/department staff (including MDT)
 Hierarchy of trust staff explained
 Tour around ward/department environment
 Nurse Call system explained
 Bleep system explained
 Location of ward/department useful contact numbers
identified
 Off duty requests explained
 Shift patterns explained
 Security door code given (if applicable)
 POD system explained
 Explain the roles of the lead/link nurses
 Familiarise yourself with lead/link nurses within the
ward/department
Fire Procedure
 Identify ward/departments fire alarm points
 Location of fire fighting equipment
and fire exits on ward/department
 Explain the fire procedure and contact number (333) to alert
switchboard of fire.
 Identify ward/departments assembly point in the event of a
fire
 Location of Fire Safety Policy identified
Cardiac Arrest Procedure
 Location of resuscitation equipment:




Resuscitation Trolley
Suction Equipment (wall mounted/portable)
Defibrillation Machine/cardiac monitor
Oxygen points and cylinders
Added to NU Placements Website May 2011
Mentor signature &
date
Student signature &
date
Mentor signature &
date


Explain the contents of the resuscitation trolley
Demonstrate how to check and record the resuscitation
trolley & Defibrillator check and frequency of checks
according to policy
 Explain procedure for Cardiac arrest and contact number
(2222) to alert switchboard to send cardiac arrest team
 Location of Resuscitation Policy identified
Manual Handling
 Location of ward/departments Moving and Handling
equipment
Health and Safety
 Emergency Security bleep number (777) explained
 Location of Health and Safety Policies (COSHH, Risk
Management, Medical Devices & Decontamination policies)
identified

Explain the difference between Oxygen and Air cylinders

Demonstrate how to set up oxygen (tubing/masks/valves)
&suctioning equipment as appropriate to the level of the
student
 Medical equipment library explained
Infection Prevention and Control
 Location of Infection Prevention and Control Policies
identified (Disinfectant, hand washing, sharps and commode
cleaning)
 MRSA Screening explained
 Explain the importance of the three times a day
cannulae/line checks
 Explain the importance of the daily catheter checks
Policies
 Location and awareness of Uniform, Mobile Phone,
Sickness reporting, Complaints, Data Protection & Equality
and Diversity Policies
Communication/Record Keeping
 The importance of consent explained
 Telephone etiquette / communication skills explained
 Demonstrate and explain the use of relevant patient
assessments:
Observation charts and EWS
Fluid Balance charts/Fluid Balance Summary Charts
Diabetic Charts
Nutrition/Food Charts
Discharge Checklists
Property lists
MUST Tool
Pressure Sore Assessment
Accident/Incident Reporting
Procedural Checklists
Audits
Additional information discussed/explained:-
Added to NU Placements Website May 2011
Student signature &
date