Bedah Laserasi Kelopak Mata pada Hewan (Bedah Veteriner)

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Bedah Laserasi Kelopak Mata pada Hewan (Bedah Veteriner)

eye anatomy

Animal eyeballs are protected by eyelids, which consist of two skins and muscles, just like the human eye. There is a lot of blood in the skin, so if there are cuts and wounds, they need to be treated properly in order to heal well and fight infection. The eyelid muscles are very strong and can open or close again.

Specialized mammalian species, such as horses and other mammals, have a third eyelid, a transparent cartilage known as the conjunctiva.

Lacrimination of animal eyelids

Laserasi kelopak mata pada hewan
eye anatomy


As seen in the image above, it is part of the outer fibrous layer of the eye, which serves to protect the surface of the eye. The cornea of ​​the eye is transparent and participates in the transmission and refraction of light.

Although it is composed of living cells, there are few or no blood vessels. The surface receives nutrients from tears, while the back is nourished by aqueous humor, which usually contains the eyeballs.

The sclera, like most, consists of collagen fibers, which are the outer layer of the fibrous layer and serve to protect the inside of the eye.

The iris and ciliary body make up the middle choroid of the eye. The iris has muscles that control the size of the pupil, which controls the amount of light that enters the eye.

The ciliary body produces fluid to keep it at the entrance of the eye. It also has muscles that allow it to focus on distant or near objects. In horses, this function is relatively weakly developed.

The lens sits behind the iris and refracts light to create an image that is focused on the retina. As here, it has no blood vessels, but is nourished by aqueous humor. The choroid is part of the middle layer of blood vessels in the eye and helps supply nutrients to the retina.

On the inside of the choroid is a layer of tissue that is thought to improve low-light vision by reflecting light back onto the retina.

The retina is made up of a network of nerves, and their function is to convert nerve impulses. The optic nerve of the retina, which carries messages from the retina to the brain.

Functions, muscles, nerves and eyelids

The eyelids act as a protective covering covering the eye, protecting the front surface of the eyeball from injury, sunlight, and foreign bodies, and preventing the apple from drying out due to the presence of the eyelids.

While the upper eyelids are very thin, the lower eyelids are slightly thicker, and the orbicularis muscle acts as the eyelid sphincter muscle. This muscle is innervated by the temporal and zygomatic branches of the facial nerve.

This muscle is divided into three parts: the anterior abdominal muscle, the anterior septal muscle, and the anterior orbital muscle. The facial nerve drives the circular muscle of the eye, which closes the eyelid.

The oculomotor nerve is the motor of the levator muscle of the upper eyelid. The trigeminal sensory nerve of the eyelids.

The eyelids are composed of meibomian glands (heel bone glands), sebaceous glands, Zeiss glands, sebaceous glands associated with eyelash follicles called Mohl glands, and sweat glands adjacent to the Zeiss glands.

Causes of broken eyelids

There are several mechanisms by which sharp or pointed objects around the eyes can cause watery eyes. Even sharp, harmless objects can tear. It can also be caused by other animals scratching their eyelids.




Laserasi kelopak mata pada hewan
Fracture of the upper eyelid in horses


laserasi kelopak mata pada hewan





Diagnosis of eyelid laceration

Bruises often cause swelling and bleeding of the eyelids. It should be noted that sudden inflammation occurs because it allows for deviations in the intraocular structure of the retina as a result of blunt trauma.

Damage to the orbital bones can also occur in this situation. Ultrasound or X-ray can be done to determine the condition of eye structures.

Eyelid tears can be detected on examination. The edges of the eyelids are irritated, heavy bleeding occurs.

Eyelid lacerations occur at the time of death and can affect the deeper structures of the eye. If you cut the orbital muscle of the eye, the edges of the wound do not compress this muscle. It should be noted that a wound of a different nature indicates the loss of circular tissue due to trauma.

The site (upper/lower eyelids, medial/lateral, or central canal), affected structures (skin, connective tissue, muscles, conjunctival folds, and possibly the eyeball or lacrimal system), tissue loss, and potential contamination are needed to ensure appropriate treatment. evaluate.. (duration, side cases, reason for separation).

treatment or treatment

Animal eyelid wounds can be treated surgically or non-surgically.


Preparation for laser eyelid surgery

Eyelid contusion usually does not require treatment, but systemic use of flunixin meglumine and use of air compresses during the acute phase or warm compresses the day after the injury may relieve eyelid swelling and reduce tenderness. Damage to organ structures requires more adequate treatment.

Eyelid wounds should be closed immediately. Closure should be performed under general anesthesia such as sedation and local anesthesia.

Prior to closure, the wound should be disinfected of pus and debris, the lid surface should be disinfected if necessary, and over-treatment of the wound should be avoided as this will interfere with proper positioning.

There are many blood vessels in the eyelids, so the tissues make it difficult to close the wound. Therefore, the tissue flap cannot be removed at all.

The wound should be closed as close as possible, starting from the eyelid margin, with a special figure-of-eight thread starting 1-2 mm from the tip (from the original site of hair growth) and using the exact edge of the meibomian gland. guide. for appointment

Preparation of eyelids

  1. A surgical scrub containing iodine is recommended because chlorhexidine has been shown to be toxic to the protective epithelium.
  2. The brush can be protected with petroleum jelly, minimizing contact with objects. After preparing for tear surgery, pay attention to the presence of foreign bodies around the eyes.
  3. If the wound occurs within 12-24 hours, initial closure should be performed immediately. If the wound persists for more than 24 hours and there is inflammation, wound care and antibiotics will be given, followed by delayed wound closure (delayed primary closure).
  4. Conduct a thorough eye evaluation, if there are no abnormalities, it will be easier to close. If a fracture occurs with delayed primary closure, it is evaluated and treated accordingly.

Technological stages of eyelid fracture surgery

As a general rule, a simple two-layer repair, if performed with care, will be sufficient to provide a functional and cosmetic result. Here are some steps of tear eyelid surgery.

  1. The first layer is a suture with interrupted sutures behind the mattress, which is placed between the conjunctiva and the skin overlying the stroma. If the conjunctiva is close to the fleshy surface, it usually does not require stitches.
  2. The first point of this layer is the most important in the entire repair process and requires complete closure of the suture on the fracture surface. 3-0 or 4-0 with absorbable chrome gut and special ophthalmic needle. Repair optimization can reduce closed edge discontinuity. Great care must be taken especially during the first stitch to ensure integrity after stitching.
  3. Also in the second layer, care should be taken to improve the alignment of the closed edges and ensure that the seam does not come into contact with the contacts. The second layer has a simple skin setting and breakpoint pattern using 3-0 or 4-0 polypropylene or flame-retardant nylon. The second layer is usually processed within 14 days to maintain maximum fabric strength.
  4. After fixing the eyelids, it is important to fix the eye. If the injury is severe enough to cause a tear, the most likely cause is uveitis. And if signs of uveitis appear, further treatment is necessary.
  5. Topical corticosteroids should be treated because they interfere with wound healing and do not reduce the risk of developing keratosis pilaris, which can cause defects in the surrounding epithelium.
  6. Careful evaluation to rule out the presence of foreign bodies or epithelial damage. Use fluorescent lights with UV light (Woods lights can be very useful for detecting bulb pests). If there is no wooden lamp, it is cheaper to use a "black light" lamp.


Then he knows

Topical and systemic antibiotics (trimethoprim-sulfonamide or penicillin) are usually given within 5 to 7 days of improvement. During recovery, non-steroidal anti-inflammatory drugs are also prescribed (phenylbutazone or flunixin meglumine three to five days after improvement). Finally, if necessary, tetanus toxoid should be administered.


Reference:

Fossem, TW2013, Small Animal Surgery, University of Veterinary Medicine. Texas

Ferraro, Gregory L. 2009. Horse eyes. University of California, Davis College of Veterinary Medicine


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