25 Ophthalmic Surgery
CHAPTER LESSON PLANS & OBJECTIVES
Lesson 25.1: Anatomy and Diagnostics
- 1. Identify key anatomical structures of the eye
- 2. Discuss common diagnostic procedures of the eye
Lesson 25.2: Case Planning, Techniques, and Procedures
- 3. Discuss specific elements of case planning for eye surgery
- 4. Discuss surgical techniques used in eye surgery, including use of the operating microscope
- 5. Describe common surgical procedures of the eye
Classroom Preparation
Lesson 25.1: Anatomy and Diagnostics
INSTRUCTOR PREPARATION
Textbook Objectives Covered
- 1. Identify key anatomical structures of the eye
- 2. Discuss common diagnostic procedures of the eye
National Standards Covered
- • See the Fuller 8e/AST Core Curriculum Mapping Guide on Evolve instructor resources.
Classroom Preparation
Lesson 25.1: Anatomy and Diagnostics
STUDENT PREPARATION (1 hr)
| 1 | READ – Chapter Heading(s) • Introduction • Surgical Anatomy Orbital Cavity Eyelids Globe Eye Muscles Conjunctiva Cornea Sclera Choroid Layer and Ciliary Body Iris Retina Lens Anterior and Posterior Chambers Lacrimal Apparatus ANSWER – Textbook • Review Question 5 ANSWER – Workbook • Chapter 25 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 2 | READ – Chapter Heading(s) • Refraction • Diagnostic Testing ANSWER – Workbook • Chapter 25 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
50-Minute Lesson Plan
Lesson 25.1: Anatomy and Diagnostics
LECTURE OUTLINE (50 min)
| POWERPOINT SLIDES | CHAPTER HEADING(S) | |
| 1 | ANATOMY: SLIDE 4 | • Introduction • Surgical Anatomy Orbital Cavity Eyelids Globe Eye Muscles Conjunctiva Cornea Sclera Choroid Layer and Ciliary Body Iris Retina Lens Anterior and Posterior Chambers Lacrimal Apparatus |
| 2 | DIAGNOSTICS: SLIDES 5-7 | • Refraction • Diagnostic Testing |
Learning Activities (choose one or more to equal 50 min)
| 1 | REVIEW (30 min) • On the board, draw a large circle representing an orbit, with the cornea toward the top of the board. One at a time, have each student come to the board and add an anatomical feature to the drawing and label it. • Appropriate Settings: Traditional classroom |
| 2 | DISCUSS (30 min) • Break the class into small groups. Assign each group a type of ophthalmic diagnostic test. Each group should describe the indications for each test. Have a spokesperson for each group share the group’s work with the class. Appropriate Settings: Traditional/online/flipped classroom |
Critical Thinking Question
Why is verification of the operative site so critical? What steps should the operating room (OR) team take to ensure the safety of the patient?
Discussion Guidelines: Correct-site surgery is a major safety goal in patient care. All members of the team must concern themselves and share responsibility for the verification activity. Among the safety precautions taken in surgical centers is asking the patient (before administration of anesthesia) to verify the surgical site. Other steps often include marking the surgical site on the patient; in some settings medical personnel will initial these marks to verify who marked and confirmed the site. The marked location is compared with the medical record to confirm the surgical site before the start of surgery.
Classroom Preparation
Lesson 25.2: Case Planning, Techniques, and Procedures
INSTRUCTOR PREPARATION
Textbook Objectives Covered
- 3. Discuss specific elements of case planning for eye surgery
- 4. Discuss surgical techniques used in eye surgery, including use of the operating microscope
- 5. Describe common surgical procedures of the eye
National Standards Covered
- • See the Fuller 8e/AST Core Curriculum Mapping Guide on Evolve instructor resources.
Classroom Preparation
Lesson 25.2: Case Planning, Techniques, and Procedures
STUDENT PREPARATION (1 hr)
| 3 | READ – Chapter Heading(s) • Case Planning Psychological Considerations in Eye Surgery Verification of the Operative Site Positioning the Patient for Ophthalmic Surgery Prepping and Draping Anesthesia Ophthalmic Drugs Instruments • Equipment and Supplies Electrosurgical Unit Eye Sponges Sutures Ophthalmic Dressings ANSWER – Textbook • Review Questions 1, 3, 4 ANSWER – Workbook • Chapter 25 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 4 | READ – Chapter Heading(s) • Surgical Techniques in Eye Surgery Microsurgery • Role of the Scrubbed Surgical Technologist ANSWER – Textbook • Review Question 7 ANSWER – Workbook • Chapter 25 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 5 | READ – Chapter Heading(s) • Surgical Procedures Excision of a Chalazion Dacryocystorhinostomy Muscle Resection and Recession Penetrating Keratoplasty (Corneal Transplantation) Extracapsular Cataract Extraction (Phacoemulsification) Anterior Vitrectomy Scleral Buckling Procedure for Detached Retina Filtering Procedures and Trabeculectomy Removal of the Eye Repair of Entropion Lower Lid Repair of Ectropion Lower Lid Periorbital Lacerations ANSWER – Textbook • Review Questions 2, 6, 8 ANSWER – Workbook • Chapter 25 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
50-Minute Lesson Plan
Lesson 25.2: Case Planning, Techniques, and Procedures
LECTURE OUTLINE (50 min)
| POWERPOINT SLIDES | CHAPTER HEADING(S) | |
| 3 | CASE PLANNING: SLIDES 9-11 | • Case Planning Psychological Considerations in Eye Surgery Verification of the Operative Site Positioning the Patient for Ophthalmic Surgery Prepping and Draping Anesthesia Ophthalmic Drugs Instruments • Equipment and Supplies Electrosurgical Unit Eye Sponges Sutures Ophthalmic Dressings |
| 4 | SURGICAL TECHNIQUES: SLIDES 12-13 | • Surgical Techniques in Eye Surgery Microsurgery • Role of the Scrubbed Surgical Technologist |
| 5 | SURGICAL PROCEDURES: SLIDE 14 | • Surgical Procedures Excision of a Chalazion Dacryocystorhinostomy Muscle Resection and Recession Penetrating Keratoplasty (Corneal Transplantation) Extracapsular Cataract Extraction (Phacoemulsification) Anterior Vitrectomy Scleral Buckling Procedure for Detached Retina Filtering Procedures and Trabeculectomy Removal of the Eye Repair of Entropion Lower Lid Repair of Ectropion Lower Lid Periorbital Lacerations |
Learning Activities (choose one or more to equal 50 min)
| 3 | ROLE PLAY (50 min) • Break students into small groups. Have pairs of student’s role play a “special population” of geriatric patients. One student plays a hospital employee and the other plays a geriatric patient. Blindfold the patients and place cotton in their ears. Ask each employee to read an unfamiliar paragraph (such as one from a later chapter of the textbook) aloud to the patient. Next, the patient should get up, walk around the chair, and sit back down. The employee should then ask the patient specific questions about the paragraph. Regroup as a class and ask the patients to describe their experiences. How much did they remember about the reading? How well did they navigate? Students should gain a little insight into the plight of a geriatric ophthalmic patient. Appropriate Settings: Traditional classroom DEMONSTRATE (50 min) • Demonstrate the specific case planning elements for eye procedures. Include setting up the room, instruments, and special equipment. Appropriate Settings: Traditional classroom |
| 4 | INVITE (50 min) • Invite a guest to demonstrate proper setup, use, and draping of an OR microscope. Allow ample time for students to ask questions. Appropriate Settings: Traditional classroom DEMONSTRATE (50 min) • Demonstrate the specific surgical techniques used in eye procedures. Appropriate Settings: Traditional classroom |
| 5 | DISCUSS (30 min) • Break the class into small groups. Give each group a blank transparency and a marker. Each group should draw a rectangle depicting a Mayo tray. Each group should populate their “tray” with the proper instruments for an eye procedure. You may want to assign a type of procedure (e.g., cataract extraction, eye muscle procedure, eyelid procedure) to each group. Have each group share its work with the class. Appropriate Settings: Traditional/online/flipped classroom |
Critical Thinking Question
Ophthalmic procedures are frequently of short duration. To maintain efficiency and make the best use of expensive OR time, these cases tend to move very quickly, and the time between procedures (turnover time) is short. How might this pace seem for a patient? What actions might mitigate these feelings?
Discussion Guidelines: Students should recognize that each patient needs to be treated as a person, not a “case.” Patients need to be referred to by name and not as “Dr. Smith’s third case.” The day should move quickly, but patients should never feel rushed. Avoid actions or words that give the impression you are in a hurry; a calm approach conveys the idea that you are concerned about the individuals in your care. Ophthalmic patients often feel very nervous and worried about the outcome of their surgery, so an unhurried and considerate attitude is reassuring to these patients.
Assessments
Chapter 25: Ophthalmic Surgery
ASSESSMENTS BY OBJECTIVE
| 1-5 | Workbook • Chapter 25 Evolve Instructor Resources • Test Bank Create a quiz using ExamView; sort by objective. Evolve Student Resources • Mock Certification Exam • Review Questions |
| All | Elsevier Adaptive Quizzing • Chapter 25 – Graded quizzes (Mastery Levels 1, 2, and 3) |
