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Extirpation of Eye - Doxc

This document summarizes the surgical procedure for extirpation of the eyeball. It describes the relevant anatomy including the three tunics of the eyeball and surrounding structures. The surgical technique involves making an incision around the eyelid margin, separating the conjunctiva, cutting the muscles and optic nerve, and controlling hemorrhage before removing the eyeball and packing the orbital cavity. Post-operative care includes applying a pressure bandage, removing packing gradually, administering antibiotics, and removing lid sutures once healing is complete.

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kushal Neupane
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Download as DOCX, PDF, TXT or read online on Scribd
88 views

Extirpation of Eye - Doxc

This document summarizes the surgical procedure for extirpation of the eyeball. It describes the relevant anatomy including the three tunics of the eyeball and surrounding structures. The surgical technique involves making an incision around the eyelid margin, separating the conjunctiva, cutting the muscles and optic nerve, and controlling hemorrhage before removing the eyeball and packing the orbital cavity. Post-operative care includes applying a pressure bandage, removing packing gradually, administering antibiotics, and removing lid sutures once healing is complete.

Uploaded by

kushal Neupane
Copyright
© © All Rights Reserved
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Study on the surface anatomy and gross structures involved in the

surgical interferences viz extirpation of the eye ball.

Objectives:

 To be familiar with surface anatomy and structures of eye during surgery.


 To be familiar with the process of extirpation of eye ball.

Indications:

 Irreparable injuries
 Tumors

Surgical anatomy:

a. Eyeball is situated in the anterior part of the orbital cavity. It is protected infront by the
upper and lower eyelids, balbar and palpebral conjunctiva and in its middle by the
complete orbital ring.
b. Eyeball consist of three tunica’s as follows:
i. Fibrous tunic: Sclera and Cornea
ii. Vascular tunic: Choroid, Ciliary body and Iris
iii. Nervous tunic: Retina within which three refractive media: aqueous humor, lens
substance and viterous humor are enclosed.
c. The third eyelid or membrane nictitans is situated at the anteromedial angel of the eye.
d. The movement of eyeball is controlled by four straight muscles, two oblique muscles and
a retractor muscle. There are four straight muscles named rectus dorsalis, ventralis,
medialis and lateralis.
e. There are two oblique muscles namely oblique dorsalis and oblique ventralis.
f. The retractor muscles helps to draws the whole eyeball backwards.
g. The most common gland in and around the eyeball are lacrimal gland. It is situated in the
dorso- lateral aspect of eyeball and it helps to lubricate the cornea and acts as
bactericidal.
h. Nerve supply to eyeball are as follows:
a. Motor nerve: Occulomotor, Cochlear, Abducent, Trigeminal
b. Sensory nerve: Optic nerve
i. Artery and vein are ophthalmic artery and ophthalmic vein.

Site of operation:
Between eyeballs and orbital rim through the skins of both eyelid about ½ cm from the border.
Surgical Technique:

1. The upper and lower eye lids are sutured together with a continuous suture
leaving the suture ends at least 15-20 cm long for grasping and applying traction
during the operative procedure.
2. An incision completely encircling the eye lids is made approximately ½ cm
from the margin of the lids .
3. The incision is extended around the entire circumference of the lid margin
between the orbital rim and eye ball by blunt dissection taking care that conjunctiva
is not punctured.
4. Haemorrhage is carefully controlled either by ligation or forcipressure.
5. Conjunctiva from the lids to its attachment to the orbit is separated leaving
attachment to the border of the lids .The dissection is carried out back to the point
of insertion of the conjunctiva to the orbit.
6. All the muscles of the eye are incised with scissors and finally the optic
nerve is cut. .Before cutting, the optic vessels are legated firmly in order to control
the haemorrhage.
7. All the periorbital fat is left in place.
8. The haemorrhage is controlled with gauze pressure temporally packed up
inside the orbital cavity. All the blood clots remove from the orbital cavity.
9. Temporary pack is removed and a 70-80 cm long piece of bandage
impregnated in antiseptic lotion is inserted into the orbital cavity. Outer skin edges
of the lids are sutured with interrupted sutured in order to close the wound leaving
a little portion of impregnated gauze towards the inner canthus.

Post Operative Care:

1. A pressure bandage should be tied for about 24 hours after the operation.
2. A 15-20 cm piece of impregnated bandage should be removed on 3 rd or 7th
day, and the rest on 10th day after the operation.
3. A course of antibiotics should be administered for 4-5 days or till the
healing is complete.
4. The sutures of the lids should be removed 8-10 days after the operation or
till the healing is complete.

Conclusion

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