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Chapter Thirteen
EYE AND ADNEXA
Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc.
The Eye and the Adnexa
 Functions
 Vision (ocul/o, ophthalm/o)

Capture and focus versus interpretation of images
 Anatomy and physiology
 Eye
Oculus sinistra
 Oculus dextra
 Oculus uterque


Ocular adnexa
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Word Parts
ophthalm/o, ocul/o =
eye
orbit/o = orbit/o
blephar/o, palpebr/o =
eyelid
 Ocular adnexa
 Orbit
 Eyebrows
 Canthi
 Eyelids
Palpebral fissure
 Palpebration

canth/o = canthus
conjunctiv/o =
conjunctiva

Conjunctivae
Ocular adnexa
Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc.
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CM Guideline Alert
B13. Laterality
 For bilateral sites, the final character of the codes in
the ICD-10-CM indicates laterality. An unspecified
side code is also provided should the side not be
identified in the medical record. If no bilateral code
is provided and the condition is bilateral, assign
separate codes for both the left and right side.
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Be Careful!
 Tars/o can refer to a flat structure that gives shape to
the eyelid (the tarsal plate) or to bones in the ankle.
From the Greek word tarsus meaning of a flat
surface, it refers to the horizontal level appearance of
each eyelid and also the bones that make up the
instep of the foot.
 The term palpebrate means to blink or wink. Do not
confuse this with the term palpate (meaning to
touch) or palpitate (meaning to throb).
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Word Parts
dacryoaden/o =
lacrimal (tear glands)
dacryocyst/o = lacrimal
(tear) sac
lacrim/o, dacry/o =
tears
Glands



Meibomian
Lacrimal
Lacrimation
Lacrimal glands
 Lacrimal sacs
 Nasolacrimal ducts

nas/o = nose
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Extraocular muscles
Word Parts

extra- = outside

ocul/o = eye


-ar = pertaining to
rect/o = straight
annul/o = annulus, ring
Rectus
Oblique
Annulus of Zinn


Don’t confuse with the zonules of Zinn
Levator palpebrae
Orbicularis oculi
palpebr/o = eyelid
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The Eyeball
Eyeball viewed
from above
Anterior view
of the eyeball
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Word Parts
scler/o = sclera
epi- = above, upon
kerat/o, corne/o =
cornea
limb/o = limbus
Eyeball

Outer layer/fibrous tunic

Sclera
 Episcleral layer
 Schlemm’s canal
• Scleral venous sinus
Eyeball
Trabecular network
 Cornea
 Limbus

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Be Careful!
 The combining form kerat/o refers to the structure of
the cornea, but also to the condition of a body part
having a “hard or horny” appearance, such as a
seborrheic keratosis.
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Word Parts
uve/o = uvea
choroid/o = choroid
cycl/o = ciliary body
ir/o, irid/o = iris
pupill/o, core/o, cor/o
= pupil
phak/o, phac/o = lens
 Middle layer/vascular tunic
 Uvea (choroid, ciliary body, iris)
Iris
 Pupil
 Ciliary body
 Pars plana
 Zonule of Zinn
 Crystalline lens
 Aqueous and vitreous humors

vitre/o = vitreous
humor
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Be Careful!
 Core/o and cor/o are combining forms for the pupil
of the eye and corne/o is a combining form for the
cornea.
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PCS Guideline Alert
 B2.1 Body systems contain body part values that
include contiguous body parts. These general body
part values are used:



a. when a procedure is performed on the general body part as a
whole
b. when the specific body part cannot be determined
c. in the root operations change, removal and revision, when
the specific body part value is not in the table.
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Word Parts
retin/o = retina
papill/o = optic disk
macul/o = macula lutea
Inner layer/nervous tunic

Retina
Rods
 Cones
 L, M, S
 Macula lutea
 Fovea centralis
 Optic disk
 Optic papilla
 Ora serrata

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Vision
 Refraction
 Errors of refraction
 Accommodation
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Clicker Question
 A combining form for the lens is:
A. palpebr/o
B. phak/o
C. cor/o
D. cycl/o
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Word Parts
blephar/o = eyelid
-itis = inflammation
-chalasis = relaxation
-ptosis = drooping,
sagging, prolapse
Disorders of the Eyelid,
Lacrimal System, and Orbit
(H00-H05)
 Blepharitis
 Blepharochalasis
 Blepharoptosis
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Review Question
 What is the term for a drooping of the upper eyelid?
A. blepharitis
B. blepharochalasis
C. blepharoptosis
D. entropion
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Word Parts
dacryoaden/o =
lacrimal gland
-itis = inflammation
dacryocyst/o = lacrimal
sac
lacrim/o = tear
canalicul/o = little
canal
Disorders of the Eyelid,
Lacrimal System, and Orbit
(H00-H05)
 Dacryoadenitis
 Dacryocystitis
 Lacrimal canaliculitis
 Epiphora
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Word Parts
ex- = out
ophthalm/o = eye
-os = condition
Disorders of the Eyelid,
Lacrimal System, and Orbit
(H00-H05)
 Chalazion
 Hordeolum
 Exophthalmos
Chalazion
Exophthalmos
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Hordeolum
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Word Parts
ec- = out
trop/o = turning
-ion = process of
Disorders of the Eyelid,
Lacrimal System, and Orbit
(H00-H05)
 Ectropion
 Entropion
en- = in
Ectropion
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Entropion
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Word Parts
conjunctiv/o =
conjunctiva
-itis = inflammation
pteryg/o = wing
-ium = structure
Conjunctiva Disorders (H10H11)
 Conjunctivitis
 Pinguecula

Pingueculitis
 Pterygium
Conjunctivitis
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Word Parts
hypo- = under
hem/o = blood
-a = noun ending
irid/o = iris
cycl/o = ciliary body
-itis = inflammation
kerat/o = cornea
-malacia = softening
scler/o = sclera
Disorders of Sclera, Cornea,
Iris, and Ciliary Body (H15H22)
 Hyphema
 Iridocyclitis
 Keratitis
 Keratomalacia
 Scleritis
 Synechia
 Uveitis
uve/o = uvea
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Word Parts
a- = no, not, without
phak/o = lens
Disorders of the Lens (H25H28)
 Aphakia
 Cataract
-ia = condition
Cataract
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Word Parts
cycl/o = ciliary body
-itis = inflammation
retin/o = retina
-al = pertaining to
isch/o = hold back,
suppress
-emia = blood condition
Disorders of Choroid and
Retina (H30-H36)
 Age-related macular degeneration
(ARMD or AMD)
 Posterior cyclitis
 Retinal ischemia
 Retinal tear, retinal detachment
 Retinitis pigmentosa
ARMD
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Word Parts
glauc/o = gray, bluish
green
-oma = mass, tumor
Glaucoma (H40-H42)
 Glaucoma


Chronic/primary angle glaucoma
Angle-closure/narrow-angle glaucoma
Open-angle glaucoma
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Word Parts
pan- = all
ophthalm/o = eye
Disorders of Vitreous Body
and Globe (H43-H44)
 Panophthalmitis
 Purulent endophthalmitis
-itis = inflammation
endo- = within
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Word Parts
opt/o = vision
-ic = pertaining to
neur/o = nerve
-itis = inflammation
papill/o = optic disk
Disorders of Optic Nerve and
Visual Pathways (H46-H47)
 Optic neuritis
 Optic papillitis
 Papilledema
 Retrobulbar neuritis
-edema = swelling
retro- = behind
bulb/o = globe
-ar = pertaining to
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Word Parts
eso- = inward
trop/o = turning
-ia = condition
exo- = outward
hyper- = excessive
metr/o = measure
-opia = vision condition
my/o = to shut
presby- = old age
Disorders of Ocular Muscles,
Binocular Movement,
Accommodation and
Refraction (H49-H52)
 Astigmatism (astig. As, Ast)
 Esotropia
 Exotropia
 Hypermetropia/hyperopia
 Myopia (MY)
 Presbyopia
 Strabismus
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Word Parts
a- = no, not, without
chromat/o = color
-opsia = vision condition
ambly/o = dull, dim
-opia = vision condition
ex- = without
an- = no, not, without
dipl/o = double
hemi- = half
nyctal/o = night blindness
phot/o = light
-phobia = condition of fear,
sensitivity
Visual Disturbances and
Blindness (H53-H54)
 Achromatopsia
 Amblyopia ex anopsia
 Diplopia
 Hemianopsia
 Nyctalopia
 Photophobia
 Scotoma
scot/o = darkness
-oma = mass, tumor
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Word Parts
an- = no, not, without
is/o= equal
cor/o = pupil
mi/o = to close,
constrict
Other Disorders of Eye and
Adnexa (H55-H57)
 Anisocoria
 Miosis
 Mydriasis
 Nystagmus
mydr/o = dilation
-iasis = state
Anisocoria
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Be Careful!
 Do not confuse: esotropia, exotropia, entropion,
ectropion
 Nyctalopia means night blindness, not night vision
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Word Parts
choroid/o = choroid
Benign and Malignant
Neoplasms
 Choroidal hemangioma
hemangi/o = blood
vessel
-oma = tumor, mass
 Intraocular melanoma
intra- = within
 Retinoblastoma
ocul/o = eye
melan/o = dark, black
retin/o = retina
blast/o = embryonic,
immature
Retinoblastoma
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Review Question
 What is the term for loss of half of one’s visual field?
A. nyctalopia
B. scotoma
C. achromatopsia
D. hemianopsia
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Word Parts
goni/o = angle
-scopy = viewing
ophthalm/o = eye
Diagnostic Procedures
 Amsler grid
 Diopters
 Fluorescein staining
 Gonioscopy
 Ophthalmoscopy
Amsler grid showing visual changes
caused by fluid leakage
under the retina
From Seidel: Mosby’s guide to physical examination, ed 6, Mosby
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Diagnostic Procedures
 Schirmer tear test
 Slit lamp examination
Snellen
chart
 Tonometry
 Visual acuity
(VA) assessment

Snellen chart
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Terms Related to Diagnostic Procedures
 Visual field
(VF) test
Assessment of visual fields
From Black and Hawks: Medical-surgical nursing, ed 8, Saunders
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Review Question
 Which diagnostic procedure is used to visualize the
angle of the anterior chamber of the eye?
A. ophthalmoscopy
B. gonioscopy
C. ophthalmic sonography
D. tonometry
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Word Parts
blephar/o = eyelid
-plasty = surgically
forming
canth/o = corner (of eye)
Procedures
 Blepharorrhaphy
 Canthorrhaphy
 Conjunctivoplasty
 Cyclodiathermy
-rrhaphy = suturing
conjunctiv/o =
conjunctiva
cycl/o = ciliary body
dia- = through
therm/o = temperature,
heat
-y = process of
Blepharoplasty
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Procedures
 Enucleation of eyeball
 Evisceration of eyeball
Enucleation of eyeball
From Swartz: Textbook of physical diagnosis, history
and examination, ed 5, Saunders
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Word Parts
kerat/o = cornea
-tomy = cutting
-ectomy = cutting out
-plasty = surgically
forming
-milieusis = Greek word
for carving
Refractive, Scleral, and
Corneal Procedures
 Radial keratotomy
 Keratectomy
 Keratoplasty
 Laser-assisted in situ
keratomileusis (LASIK)
LASIK
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Word Parts
phac/o = lens
Lens Procedures
 Phacoemulsification with/without
intraocular lens (IOL)
ex- = out
tract/o = pull
intra- = within
extra- = outside
ocul/o = eye
Cataract extraction
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Word Parts
irid/o = iris
-ectomy = cutting out
Iris Interventions
 Iridectomy
 Iridoplasty
-plasty = surgically
forming
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Word Parts
vitre/o = vitreous
humor, glasssy
Retina Interventions
 Vitrectomy

Scleral buckling
-ectomy = cutting out
scler/o = sclera, hard
Scleral
buckling
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Pharmacology
 Antibiotics
 Antiglaucoma drugs
 Antihistamines
 Cycloplegics
 Lubricants
 Miotics
 Mydriatics
 Ophthalmics
 Topical anesthetics
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Review Question
 Which of the following is a procedure to repair the
pupil?
A. scleral buckling
B. goniotomy
C. keratectomy
D. coreoplasty
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Recognizing Suffixes for PCS
 -ectomy
 -plasty
 -rrhaphy
 -tomy
excision, resection
reposition, repair, replacement,
supplement
repair
drainage, repair
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Sort these terms into their correct categories
Terms
1. diopters
2. keratitis
3. canthus
4. scleral buckling
5. xerophthalmia
Categories
__ A+P
__ Pathology
__ Procedures
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