Welcome to Main Theatres Ophthalmology

Document Sample
Welcome to Main Theatres Ophthalmology Powered By Docstoc
					   Welcome
     to
Main Theatres




Ophthalmology
    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
              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 co-
ordinating 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.
There are 13 different consultant ophthalmologists
who operate regularly in our department :

-   Mr Inglesby      : vitreo-retinal surgery
-   Mr Fetherston    : vitreo-retinal surgery
-   Mr Steele       : vitreo-retinal surgery
-   Mr Morgan        : corneal surgery
-   Mr Bell          : corneal surgery
-   Mr Danjoux       : corneal surgery
-   Mr Boyce          : lid and plastics surgery
-   Miss Chapman    : lid and plastics surgery
-   Mr Tiffin       : paediatric ophthalmic surgery
-   Mr Gnanaraj     : paediatric ophthalmic surgery
-   Mr Allchin       : strabismus (squint) surgery
-   Mr Fraser        : glaucoma surgery
-   Mr Wood         : ophthalmic oncology surgery

There are 2 other surgeons who specialise in fast track
cataract surgery.

- Mr Phelan
- Mr Allen

Both of these surgeons are based in Cataract
Treatment Centre and only operate in our theatres on
emergency cases.
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.
       MAIN THEATRE : Nursing Staff

Kath Stoddart – Department Manager
Kath Yates - paediatric link/leaflet link

Team One
Dorothy Arrowsmith (oncology /control infection)
Clare Smith
Santy Nocon   (clinical supervision/manual handling)
Bettsy Juan         (health and safety)
Rodel Tirados       (control of infection)
Elsa Joseph
Maria Manuel
Paul Dean

Team Two
Steve Dodds (Hiss/clinical supervision /Education)
Maureen Waites (COSHE/CPR)
Michelle Dunn   (NVQ/education)
Raj Boyjonauth
Beena Toji
Sahlee Alonzo
Nicola Taylor
Pauline Price

O.D.P. Trevor Duell
             Theatre Timetable 2006



Monday    Am Th. 1   Mr Tiffin        Paediatrics
             Th. 2   Mr Morgan        Corneal/Mix
Monday    Pm Th. 1   Mr Fraser        Cataract/Glaucoma
             Th. 2   Vitreo-retinal   Emergency List
Tuesday   Am Th. 1   Miss Chapman     Lids/Plastics
             Th. 2   Mr Steel         Vitreo-retinal
Tuesday   Pm Th. 1   Mr Allchin       Strabismus
             Th. 2   Mr Boyce         Lids/Plastics
Wednesday Am Th. 1   Mr Allchin       Strabismus
             Th. 2   Mr Inglesby      Vitreo-retinal
Wednesday Pm Th. 1   Mr Allchin       Strabismus
             Th. 2   Mr Steel         Vitreo-retinal
Thursday  Am Th. 1   Mr Fetherston    Vitreo-retinal
             Th. 2   Mr Gnanaraj      Paediatric/Mix
Thursday  Pm Th. 1   Mr Boyce         Lids/Plastics
             Th. 2   Mr Morgan        Corneal/mix
Friday    Am Th. 1   Mr Boyce         Lids/Plastics
             Th. 2   Mr Inglesby      Vitreo-retinal
Friday    Pm Th. 1   Miss Chapman     Lids/Plastics
             Th. 2   S.R.             Minor Ops
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   46281

Direct Line        0191 569 9156

Line Extension     46280

Coffee Room        46283

Sister’s Office    46282
        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
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 word. 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.
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).
 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.
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.
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 anti-
biotic 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
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
involves surgical creation of a new passage of drainage
for tears into the nasal cavity.
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.
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.
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 post-
operatively 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.
                  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.
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
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.
Profile of Learning Opportunities

Learning Opportunity       Resource / Relevant
                           Personel / Department

Use Of Telephone
  - making calls
  - answering calls
  - ring back facility     Theatre Nursing Staff
  - awareness who to
    report to
  - bleep system

Using HISS / Computers
  - patient admission
    profiles / information Theatre Nursing Staff
  - order entry
  - retrieve results
  - internet               Library Staff
  - email access

Participation
  - patient care           Nursing and medical staff
  - MDT                    MDT members

Patient Care
  - prioritising patient
     needs
  - different methods of
     care delivery e.g.
      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          Theatre Nursing Staff
  -   instillation eyedrops     Anaesthetist
  -   A-scanning                Medical Staff
  -   IOP measurement           ODP’s
  -   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                    Theatre Nursing Staff
  - source and spread of        Infection Control
    infection               Department
  - aseptic technique       Infection control link
  - appropriate             nurse
    equipment,clothing

Oncology
  - epidemiology /          Theatre Nursing Staff
    aetiology               Ward Nursing Staff
  - treatment               Ophthalmic Oncology
  - surgery – radioactive   Specialist – Mr Wood
    plaque
  - isolation nursing

Ophthalmology               Eye Infirmary Nursing
  - anatomy of eye          Staff
  - diseases e.g.cataract   Learning Zones e.g. CTC,
  - treatment               Haygarth, OPD, A+E
  - surgery                 Medical Staff
  - ophthalmic pharmacy     Pharmacist
  - pre-assessment          Outpatient B : pre-
  - oculoplastics           assessment
  - nurse led post op
    clinics
  - nurse led glaucoma
    clinics
  - outreach clinics

Health Promotion
  - patient education       All Nursing and Medical
  - health promotion        Staff
    literature              Smoking Cessation Advisor
  - smoking cessation        LVA unit
  - low visual aids

Communication Skills
  - assessment /             Theatre Nursing Staff
    discussion / education   Pre-assessment Nursing
    patients and relatives   Staff in CTC and Haygarth
  - interviewing /           Ward
    questioning skills
    during assessment

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
        GLOSSARY OF OPHTHALMIC TERMS

Abduction                Turning the eye outwards.
Acanthamoeba             A genus of free-living
                         amoeba.
Accommodation            The ability of the lens to
                         change shape to allow near
                         objects to be focused on
                         the retina.
Adduction                Turning the eye inwards.
Amblyopia                Reduced vision usually due
                         to interference with the
                         eye’s development.
Alpha, Gamma and Kappa   Different angles in the
                         eye measured between
                         the optic axis and the
                         visual axis.
Aniridia                 Absence of the iris.
Aphakia                  Absence of the lens.
Applanation tonometry    Measurement of the
                         intra-ocular pressure by
                         flattening the cornea.
Arcus senilis            Degenerative change in
                         the cornea resulting in a
                         white ring around the
                         corneal circumference.
Argon laser              Laser that uses
                         photocoagulation.
Astigmatism            Uneven curvature of the
                       cornea.

Binocular vision       Co-ordinated use of both
                       eyes resulting in a single
                       vision.
Biometry               Measurement of the axial
                       length of the eye.
Blepharitis            Inflammation of the lid
                       margin.
Blepharospasm          Painful involuntary spasm
                       of the eyelids.
Blind spot             Optic disc where there
                       are no nerve endings, only
                       nerve fibres.
Bullous keratopathy    Oedema of the cornea
                       causing ‘blister’ formation
                       in the epithelium.
Canthus                Outer and inner areas
                       where the upper and lower
                       lids meet.
Capsulotomy            Opening of the capsule of
                       the lens.
Cartella shield        Plastic shield to protect
                       the eye.
Caruncle               Small fleshy area in inner
                       corner of the eye.
Cataract               Opacity of the lens.
Central field/vision   Area of vision when
                       looking straight ahead.
Chalazion          Meibomian gland cyst.
                   Internal hordeolum.
Chemosis           Oedema of the
                   conjunctiva.
Chlamydia          Chronic conjunctivitis
                   caused by serotypes D-K
                   of Chlamydia trachomatis.
Commotio retinae   Oedema of the retina
                   following trauma.
Concave lens       A lens which diverges
                   light rays, used to correct
                   myopia: a ‘minus’ lens.
Concretion         Lipid deposit in the
                   conjunctiva.
Convex lens        A lens which converges
                   light rays, used to correct
                   hypermetropia: a ‘plus’
                   lens.
Cycloplegia        Paralysis of the ciliary
                   muscles.
Cylindrical lens   A lens of cylindrical
                   shape, which refracts
                   light rays in various
                   directions in different
                   meridians, used to correct
                   astigmatism.
Dacryoadenitis     Inflammation of the
                   lacrimal gland.
Dacryocystitis     Inflammation of the
                   lacrimal sac.
Dacryocystorhinostomy   An operation to make a
                        passage from the lacrimal
                        sac into the nose to
                        overcome obstruction.
Dendritic ulcer         A branching ulcer of the
                        cornea caused by the
                        herpes simplex virus.
Descemetocele           Protrusion of Descemet’s
                        membrane through the
                        stroma and epithelium of
                        the cornea.
Dioptre                 Unit of measurement of
                        strength of the refractive
                        power of the eye, or
                        lenses, expressed as a
                        fraction of a metre.
Diplopia                Double vision.
Disciform keratitis     Inflammation of the
                        cornea as a complication
                        of herpes simplex virus.
Distichiases            Double row of eyelashes.
Drusen                  Small yellow nodule in
                        Bruch’s membrane or optic
                        nerve.
Ectropion               Turning out of the eyelid.
Electroretinogram       A recording of electrical
                        activity of the retina.
Emmetropia              Absence of refractive
                        error.
Endophthalmitis    Inflammation/infection of
                   inner structures of the
                   eye.
Endophthalmos      Displacement of the
                   eyeball downwards.
Entropion          Turning inwards of the lid
                   margin.
Enucleation        Removal of eyeball and
                   length of optic nerve.
Epicanthus         Broad fold of skin in inner
                   canthus.
Epilation          Removal of an eyelash.
Epiphora           Watering eye.
Episcleritis       Inflammation of the
                   episcleral vessels.
Evisceration       Removal of the contents
                   of the eyeball, leaving the
                   sclera intact.
Excimer laser      Laser used for corneal
                   surgery, eg for correcting
                   refractive errors or
                   removing corneal scars.
Exenteration       Removal of the contents
                   of the orbit, including the
                   eyeball and lids.
Exophthalmometer   Instrument for measuring
                   the degree of protrusion
                   of an eye.
Exophthalmos       Protrusion of one or both
                   eyes - usually refers to
                  that caused by thyroid
                  eye disease.
Field of vision   The entire area that can
                  be seen without moving
                  the eye.
Fields of gaze    The different areas that
                  can be seen when moving
                  the eye in all directions.
Fixation          The eyes are fixed on an
                  object centrally at a
                  chosen distance.
Floaters          Small, dark particles in
                  the vitreous.
Fundus            Posterior aspect of the
                  retina including the optic
                  disc and the macula.
Fusion            Co-ordinating the images
                  seen by both eyes into a
                  single image.
Glaucoma          Increased intra-ocular
                  pressure sufficient to
                  damage vision.
Gonioscope        A contact lens mirror used
                  to view the anterior
                  chamber angle.
Guttae (G.)       Eyedrops.
Hemianopia        Half-vision - unilateral or
                  bilateral.
Heterochromia     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.
Ishihara colour plates   Multi-coloured charts for
                         testing colour vision.
Keratitic precipitates   Plaques of protein
                         adhered to the corneal
                         endothelium in uveitis.
Keratitis                Inflammation of the
                         cornea.
Keratoconus              Conical-shaped deformity
                         of the cornea.
Keratometer              Instrument for measuring
                         the curvature of the
                         cornea.
Lacrimation              Production of tears.
Lagophthalmos            Incomplete closure of the
                         eyelids.
Lamellar graft           Partial thickness corneal
                         graft.
Laser                    Light Amplification by
                         Stimulated Emission of
                         Radiation. Energy
                         transmitted as heat.
Microphthalmos           Small eyeball.
Miotic                   Drug that constricts the
                         pupil.
Mydriatic                Drug that dilates the
                         pupil.
Myopia                   Short sight.
Oculentum (Oc.)          Eye ointment.
Operculum                A semi-circular tear in the
                         retina, covered with a flap
                         of retina.
Ophthalmia neonatorum     Severe conjunctivitis of
                          the newborn.
Ophthalmoplegia           Paralysis of the extra-
                          ocular muscles.
Ophthalmoscope            Instrument for examining
                          the retina.
Optic axis                The line through the
                          centre of the optical
                          structures of the eye.
Palpebral                 Pertaining to the eyelids.
Pannus                    Neovascularisation of the
                          cornea.
Panophthalmitis           Inflammation of the whole
                          eyeball.
Penetrating graft         Full-thickness corneal
                          graft.
Perimeter                 Instrument for measuring
                          the field of vision.
Peripheral vision/field   Area of vision outside
                          central field of vision.
Phacoemulsification       Removal of a cataract by
                          ultrasound, breaking down
                          lens matter prior to it
                          being aspirated.
Phasing                   Regular frequent
                          measurements of intra-
                          ocular pressure over a few
                          days.
Phlyctenule               Small vesicle of allergic
                          origin on limbal area of
                          conjunctiva and/or cornea.
Photophobia            Sensitivity to light.
Photopsia              Sensation of flashing
                       lights.
Phthsis bulbi          Shrunken eyeball.
Pinguecula             A yellowish overgrowth of
                       conjunctiva.
Placido’s disc         A disc with alternating
                       black and white rings for
                       reflecting onto the cornea
                       to detect any irregularity
                       in its curvature.
Presbyopia             Inability to focus for near
                       sight due to hardening of
                       the lens nucleus after the
                       age of 40 years.
Preseptal callulitis   Inflammation of preseptal
                       portion of the eyelids.
Prism                  A triangular-shaped lens
                       used to correct diplopia.
Proptosis              Protrusion of the eyeball.
Pterygium              A triangular proliferation
                       of conjunctival tissue that
                       can invade the cornea.
Ptosis                 Drooping eyelid.
Refraction             (1) Bending of light rays.
                       (2) Measurement of and
                       correction of refractive
                       errors of the eye.
Refractive surgery     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.
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
                           cornea which stain with
                           G.fluorescein.
Symblephron                Adhesion of the bulbar
                           and palpebral conjunctiva.
Sympathetic ophthalmitis   Severe uveitis in one eye
                           following trauma involved
                           the uvea of the other eye.
Synaechiae                 Adhesion of the iris (a) to
                           the lens - posterior
                           synaechiae; (b) to the
                           cornea - anterior
                           synaechiae.
Tarsorrhaphy               Suturing together of the
                           eyelids.
Tear film                  The film of liquid covering
                           the eyeball.
Tenon’s capsule            Membrane encircling globe
                           from limbus to optic nerve
                           overlying the sclera.
Tomography                 Computerised scan of the
                           optic disc.
Tonometer                  Instrument for measuring
                           intra-ocular pressure.
Topography                 A contour map of the
                           curvature of the cornea.
Toric contact lens         Contact lens to correct
                           astigmatism.
Trachoma                   Potentially blinding
                           infection of the
                           conjunctiva and cornea
                           caused by the TRIC virus.
Trichiasis      Ingrowing or inturning of
                eyelashes.
Uveitis         Inflammation of the uveal
                tract.
Visual acuity   Detailed central vision.
Visual axis     The line between a point
                viewed and the macula.
Visual field    Area of vision.
Vitrectomy      Removal of vitreous.
Xanthelasma     Fatty deposits on the
                eyelids.
Xerophthalmia   Lack of vitamin A
                resulting in corneal and
                conjunctival disease.
Yag laser       Laser that cuts holes in
                structures.
              Orientation Checklist

     To be completed as soon as possible

Checklist                             Student Mentor

Given student booklet
Preliminary interview
Identify learning needs
Department tour
Hospital / learning zones tour
Introduction to staff
Procedures for :-
   Cardiac arrest
   Fire
   Security
Location of CHS policy files
Awareness of policies
Location education files
University and CHS sickness policy
Answering telephone / messages
Location off duty file / requests
Hours of duty / shifts
         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 ?
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 ?

				
DOCUMENT INFO
Shared By:
Categories:
Tags:
Stats:
views:4
posted:9/2/2011
language:English
pages:43