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Eye surgery, also known as ocular surgery, is surgery performed on the eye or its adnexa, typically by an ophthalmologist. The eye is a very fragile organ, and requires extreme care before, during, and after a surgical procedure to minimise or prevent further damage. An expert eye surgeon is responsible for selecting the appropriate surgical procedure for the patient, and for taking the necessary safety precautions. Mentions of eye surgery can be found in several ancient texts dating back as early as 1800 BC, with cataract treatment starting in the fifth century BC. Today it continues to be a widely practiced type of surgery, with various techniques having been developed for treating eye problems.
An eyelid is a thin fold of skin that covers and protects an eye. The levator palpebrae superioris muscle retracts the eyelid, exposing the cornea to the outside, giving vision. This can be either voluntarily or involuntarily. The human eyelid features a row of eyelashes along the eyelid margin, which serve to heighten the protection of the eye from dust and foreign debris, as well as from perspiration. "Palpebral" means relating to the eyelids. Its key function is to regularly spread the tears and other secretions on the eye surface to keep it moist, since the cornea must be continuously moist. They keep the eyes from drying out when asleep. Moreover, the blink reflex protects the eye from foreign bodies.
Dry eye syndrome (DES), also known as keratoconjunctivitis sicca (KCS), is the condition of having dry eyes. Other associated symptoms include irritation, redness, discharge, and easily fatigued eyes. Blurred vision may also occur. Symptoms range from mild and occasional to severe and continuous. Scarring of the cornea may occur in untreated cases.
A chalazion or meibomian cyst is a cyst in the eyelid usually due to a blocked meibomian gland, typically in the middle of the eyelid, red, and not painful. They tend to come on gradually over a few weeks.
The conjunctiva is a tissue that lines the inside of the eyelids and covers the sclera. It is composed of non-keratinized, stratified squamous epithelium with goblet cells, stratified columnar epithelium and stratified cuboidal epithelium. The conjunctiva is highly vascularised, with many microvessels easily accessible for imaging studies.
The lacrimal glands are paired exocrine glands, one for each eye, found in most terrestrial vertebrates and some marine mammals, that secrete the aqueous layer of the tear film. In humans, they are situated in the upper lateral region of each orbit, in the lacrimal fossa of the orbit formed by the frontal bone. Inflammation of the lacrimal glands is called dacryoadenitis. The lacrimal gland produces tears which are secreted by the lacrimal ducts, and flow over the ocular surface, and then into canals that connect to the lacrimal sac. From that sac, the tears drain through the lacrimal duct into the nose.
Blepharoplasty is the plastic surgery operation for correcting defects, deformities, and disfigurations of the eyelids; and for aesthetically modifying the eye region of the face. With the excision and the removal, or the repositioning of excess tissues, such as skin and adipocyte fat, and the reinforcement of the corresponding muscle and tendon tissues, the blepharoplasty procedure resolves functional and cosmetic problems of the periorbita, which is the area from the eyebrow to the upper portion of the cheek. The procedure is more common among women, who accounted for approximately 85% of blepharoplasty procedures in 2014 in the US and 88% of such procedures in the UK.
The ophthalmic nerve (V1) is a sensory nerve of the face. It is one of three divisions of the trigeminal nerve (CN V). It has three branches that provide sensory innervation to the eye, the skin of the upper face, and the skin of the anterior scalp.
The tarsi are two comparatively thick, elongated plates of dense connective tissue, about 10 mm (0.39 in) in length for the upper eyelid and 5 mm for the lower eyelid; one is found in each eyelid, and contributes to its form and support. They are located directly above the lid margins. The tarsus has a lower and upper part making up the palpebrae.
The lacrimal nerve is the smallest branch of the ophthalmic nerve (V1), itself a branch of the trigeminal nerve (CN V). The other branches of the ophthalmic nerve are the frontal nerve and nasociliary nerve.
The lacrimal artery is an artery of the orbit around the eye. It arises close to the optic foramen, and is a branch of the ophthalmic artery. It accompanies the lacrimal nerve along the upper border of the lateral rectus muscle. It supplies the lacrimal gland, two rectus muscles of the eye, the eyelids, and the conjunctiva.
Tenon's capsule, also known as the Tenon capsule, fascial sheath of the eyeball or the fascia bulbi, is a thin membrane which envelops the eyeball from the optic nerve to the corneal limbus, separating it from the orbital fat and forming a socket in which it moves.
Oculoplastics, or oculoplastic surgery, includes a wide variety of surgical procedures that deal with the orbit, eyelids, tear ducts, and the face. It also deals with the reconstruction of the eye and associated structures.
The lacrimal caruncle, or caruncula lacrimalis, is the small, pink, globular nodule at the inner corner of the eye. It consists of tissue types of neighbouring eye structures. It may suffer from lesions and allergic inflammation.
Karl Friedrich Theodor Krause was a German anatomist born in Hanover.
Ciaccio's glands or Wolfring's glands are small tubular accessory lacrimal glands found in the lacrimal caruncle of the eyelid. These accessory lacrimal glands are located in the upper border of the tarsus, approximately in the middle between the extremities of the tarsal glands. Sometimes they are situated slightly above the tarsus. There are usually 2 to 5 of these glands in the upper eyelid, and their function is to produce tears which are secreted onto the surface of the conjunctiva.
Sebaceous carcinoma, also known as sebaceous gland carcinoma (SGc), sebaceous cell carcinoma, and meibomian gland carcinoma is an uncommon malignant cutaneous tumor. Most are typically about 1.4 cm at presentation. SGc originates from sebaceous glands in the skin and, therefore, may originate anywhere in the body where these glands are found. SGc can be divided into 2 types: periocular and extraocular. The periocular region is rich in sebaceous glands making it a common site of origin. The cause of these lesions in the vast majority of cases is unknown. Occasional cases may be associated with Muir-Torre syndrome. SGc accounts for approximately 0.7% of all skin cancers, and the incidence of SGc is highest in Caucasian, Asian, and Indian populations. Due to the rarity of this tumor and variability in clinical and histological presentation, SGc is often misdiagnosed as an inflammatory condition or a more common neoplasm. SGc is commonly treated with wide local excision or Mohs micrographic surgery, and the relative survival rates at 5 and 10 years are 92.72 and 86.98%, respectively.
The accessory visual structures are the protecting and supporting structures (adnexa) of the eye, including the eyebrow, eyelids, and lacrimal apparatus. The eyebrows, eyelids, eyelashes, lacrimal gland and drainage apparatus all play a crucial role with regards to globe protection, lubrication, and minimizing the risk of ocular infection. The adnexal structures also help to keep the cornea moist and clean.
Concretion in the palpebral conjunctiva, is called conjunctival concretion, that is a small, hard, yellowish-white calcified matter, superficially buried beneath the palpebral conjunctiva. Most of concretions in the eye form in the palpebral conjunctiva, which is a clear membrane to surround the inside of the eyelid; fewer can be located in the cornea and retina.
Krause's glands, Wolfring's glands and Popov's gland are the accessory lacrimal glands of the lacrimal system of human eye. These glands are structurally and histologically similar to the main lacrimal gland. Glands of Krause are located in the stroma of the conjunctival fornix, and the glands of Wolfring are located along the orbital border of the tarsal plate. These glands are oval and display numerous acini. The acini are surrounded, sometimes incompletely, by a row of myoepithelial cells. Animal studies suggest that the ducts of Wolfring glands have a tortuous course and open onto the palpebral conjunctiva. Like the main lacrimal gland, the accessory lacrimal glands are also densely innervated, but they lack parasympathetic innervation. These glands are exocrine glands, responsible for the basal (unstimulated) secretion of the middle aqueous layer of the tear film. 20 to 40 glands of Krause are found in the upper fornix, and 6-8 glands appear in the lower fornix. There are usually 2 to 5 Ciaccio's glands, and are found along the superior tarsal border of the upper eye lid. Popov’s glands are located within the substance of the caruncle.
References
- ↑ Friedman, Neil J.; Kaiser, Peter K. (2007). Essentials of Ophthalmology. Elsevier Health Sciences. p. 7. ISBN 978-1416029076 . Retrieved 11 November 2017.
- 1 2 Lemp, Michael A.; Marquardt, Rolf (2013). The Dry Eye: A Comprehensive Guide. Springer Science & Business Media. p. 58. ISBN 9783642581304 . Retrieved 11 November 2017.
