Chapter 17 Ophthalmic Surgery


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Chapter 17  Ophthalmic Surgery



Complete chapter Questions And Answers

Sample Questions




1. The refractive apparatus of the eye directs (refracts) the light rays to strike the:

  1. retina.
  2. optic nerve.
  3. vitreous body.
  4. lateral geniculate body.

Light rays from an object pass through the system of refractory devices—the cornea, aqueous humor, lens, and vitreous body—and are refracted (bent) so that the rays strike the retina.

REF: Page 613

2. The extraocular muscles work in yoked pairs, with ocular movements generated by an increase in the tone of one set of muscles and a decrease in the tone of the antagonistic muscles. Of the two muscle types, how many are represented in each eye?

  1. Two recti muscles and four oblique muscles
  2. Two superior muscles and one lateral muscle
  3. Four recti muscles and two oblique muscles
  4. Two inferior muscles and two medial muscles

Named according to their relative position on the eyeball, the extraocular muscles of the eyeball include the four recti (the superior rectus, inferior rectus, medial rectus, and lateral rectus) and two oblique muscles (the superior oblique and inferior oblique) (see Figure 17-3).

REF: Page 611

3. To accommodate near and distant focus, the lens changes shape and focus by relaxation and tightening of the zonular fibers. What physiologic change of the normal aging process is typically corrected with bifocals?
a. Cataracts

b. Presbyopia c. Glaucoma
d. Astigmatism


Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank 17-2

The lens changes shape and focus (accommodation) by relaxation and tightening of the zonular fibers. Over time (particularly after age 40), the lens and lens zonules become progressively less elastic, resulting in presbyopia. This loss of accommodative power is typically corrected with reading glasses or bifocals.

REF: Page 613

4. How does the lacrimal gland differ from the lacrimal sac?

  1. The lacrimal gland produces hormones that stimulate the lacrimal sac to secrete


  2. The lacrimal sac stores and concentrates the tears secreted by the lacrimal gland.
  3. The lacrimal gland and lacrimal sac are the same structure.
  4. The lacrimal gland secretes tears that are drained by the lacrimal sac and duct


The lacrimal apparatus effectively functions like a sink, with a faucet (main and accessory lacrimal glands) and drain (lacrimal puncta, canaliculi, sac, and nasolacrimal duct). The lacrimal gland produces tears and secretes them through a series of ducts onto the anterior ocular surface, thereby keeping the cornea moist and washing away any debris. The tears then flow inward to the puncta, from which they are conducted by the canaliculi to the lacrimal sac and finally pass into the nasolacrimal duct (see Figure 17-2).

REF: Page 610

5. A wide range of equipment is used in ophthalmic surgery. The perioperative team’s knowledge of proper operation should be confirmed through inservice education and training specific to new equipment, plus demonstrated competency. To ensure patient safety and appropriate function and application of surgical devices, which statement best reflects recommended practice when using complex biomedical equipment?

  1. Use the device according to the manufacturer’s directions and test for proper performance before the patient enters the OR.
  2. Follow the policy and procedure of the facility and/or unit, and request biomedical support.
  3. Request assistance and technical support from the appropriate vendor representative; encourage the vendor to operate the device or equipment, or request biomedical support.
  4. Follow the explanation and demonstration as originally provided by the preceptor during orientation.

For safety, all items must be used according to the manufacturer’s directions and tested for proper performance before the patient enters the OR.

REF: Page 625

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank 17-3

6. The nurse must ensure that the microscope used in ophthalmic surgery is specifically intended for safe use in eye surgery. The perioperative nurse must also be familiar with adjusting the pupillary distance (distance between pupils of the user’s eyes) and diopter settings on the oculars (eyepieces) for operator vision correction to work without eyeglasses. How should the oculars be set for a user with astigmatism?

  1. Set the oculars to the same diopters as the user’s corrective lenses.
  2. Set the oculars to the half setting of the diopters of the user’s corrective lenses.
  3. Set the oculars at zero; users should wear their eyeglasses.
  4. None of these options are appropriate for a user with astigmatism.

Proper care and maintenance of the operating microscope are essential to ensure optimal functioning and durability of this sophisticated, expensive piece of equipment typically used for intraocular procedures. Users who have astigmatism should wear their eyeglasses and set the oculars at zero.

REF: Pages 626-627

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