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Ophthalmic Surgery Chapter 16 Anatomy of the Eye Sensory organ of sight Main function is to convert environmental light energy to bioelectrical energy Relays bioelectrical information to the brain Anatomy Orbit of the eye (7 Bones) Frontal, Sphenoid, Ethmoid, Maxillary, Zygomatic, Lacrimal, and Palate. Anatomy Extrinic Muscles 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 Anatomy Anatomy Lacrimal System Lacrimal gland Lacrimal canals Lacrimal sac Anatomy 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. Anatomy Globe Conjunctiva Sclera and cornea Choroid Ciliary body Iris Retina Crystalline lens Anatomy Conjunctiva Mucous membrane covering the eye and lining the inner surface of the eyelid. Opaque and highly vascular Anatomy Sclera Opaque white portion of the eye. Comprises 5/6 of the eye maintaining the form of the globe. Cornea Transparent portion of the eye. Anterior 1/6 of the eye. Together these structures form the external tunic of the eye. Anatomy Choroid Thin, dark brown, highly vascular membrane. Firmly attached to the sclera. Ciliary Body Similar in structure to the choroid, but has larger blood vessels. Ciliary (Intrinsic) Muscle Ring muscle Anatomy 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. Choroid, Ciliary Body, and the Iris make up the middle tunic of the globe. Anatomy 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. Anatomy Crystalline Lens Transparent, biconvex body situated behind the pupil, in front of the vitreous body. Cavities and Chambers of the Eye Anterior Cavity Lies in front of the lens Two chambers Anterior chamber is anterior to the iris, but posterior to the cornea Posterior chamber is posterior to the iris, but anterior to the lens. Filled with watery fluid called aqueous humor. Cavities and Chambers of the Eye 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. Maintains pressure to keep eyeball from collapsing. Anatomy of the Eye Anatomy of the Eye Anatomy of the Eye Surgical Pathology Glaucoma Cataract Small/large retinal detachment Chalazion Strabismus Ophthalmic Medications Mydriatics Cause pupil dilation by paralyzing the iris. Atropine sulfate, Neo-Synephrine. Miotics Cause the pupil to constrict. Pilocarpine HCL Ophthalmic Medications Viscoelastic Agents Used to expand the anterior chamber during cataract surgery. Anti-inflammatory Steriods Suppresses the inflammatory response in the eye. Prednisolone Ophthalmic Medications Lubricants Local Anesthetics Protects the cornea from drying out when the eye is unable to close. Tetracaine Retrobulbar Anesthesia Injecting lidocaine or marcaine around the optic nerve. Ophthalmic Medications BSS Balanced Salt Solution Used during eye surgery to keep the cornea from drying out. STSR will typically irrigate. 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 Strabismus CorrectionRecession Scleral Buckle Enuleation Cataract extraction Common Procedures Common Procedures Common Procedures Special Considerations Patient under local anesthesia Room must be quiet More specialized equipment Personal use instrumentation Smaller suture and needles Microscope Ophthalmic medications Ophthalmic Surgery QUESTIONS?