falan42/nurse_detection huggingface dataset:
Eyelid Squamous Cell Carcinoma Excision 

PREOPERATIVE DIAGNOSIS: , Right upper eyelid squamous cell carcinoma.,POSTOPERATIVE DIAGNOSIS: , Right upper eyelid squamous cell carcinoma.,PROCEDURE PERFORMED: , Excision of right upper eyelid squamous cell carcinoma with frozen section and full-thickness skin grafting from the opposite eyelid.,COMPLICATIONS:  ,None.,BLOOD LOSS: , Minimal.,ANESTHESIA:,  Local with sedation.,INDICATION:,  The patient is a 65-year-old male with a large squamous cell carcinoma on his right upper eyelid, which had previous radiation.,DESCRIPTION OF PROCEDURE: , The patient was taken to the operating room, laid supine, administered intravenous sedation, and prepped and draped in a sterile fashion.  He was anesthetized with a combination of 2% lidocaine and 0.5% Marcaine with Epinephrine on both upper eyelids.  The area of obvious scar tissue from the radiation for the squamous cell carcinoma on the right upper eyelid was completely excised down to the eyelid margin including resection of a few of the upper eye lashes.  This was extended essentially from the punctum to the lateral commissure and extended up on to the upper eyelid.  The resection was carried down through the orbicularis muscle resecting the pretarsal orbicularis muscle and the inferior portion of the preseptal orbicularis muscle leaving the tarsus intact and leaving the orbital septum intact.  Following complete resection, the patient was easily able to open and close his eyes as the levator muscle insertion was left intact to the tarsal plate.  The specimen was sent to pathology, which revealed only fibrotic tissue and no evidence of any residual squamous cell carcinoma.  Meticulous hemostasis was obtained with Bovie cautery and a full-thickness skin graft was taken from the opposite upper eyelid in a fashion similar to a blepharoplasty of the appropriate size for the defect in the right upper eyelid.  The left upper eyelid incision was closed with 6-0 fast-absorbing gut interrupted sutures, and the skin graft was sutured in place with 6-0 fast-absorbing gut interrupted sutures.  An eye patch was placed on the right side, and the patient tolerated the procedure well and was taken to PACU in good condition.ophthalmology, frozen section, full-thickness skin grafting, squamous cell carcinoma, eyelid, orbicularis,
Cataract Extraction & Vitrectomy 

PREOPERATIVE DIAGNOSIS: , Cataract to right eye.,POSTOPERATIVE DIAGNOSIS: , Cataract to right eye.,PROCEDURE PERFORMED:  ,Cataract extraction with intraocular lens implant of the right eye, anterior vitrectomy of the right eye.,LENS IMPLANT USED:  ,See below.,COMPLICATIONS: , Posterior capsular hole, vitreous prolapse.,ANESTHESIA:  ,Topical.,PROCEDURE IN DETAIL:  ,The patient was identified in the preoperative holding area before being escorted back to the operating room suite.  Hemodynamic monitoring was begun.  Time-out was called and the patient eye operated upon and lens implant intended were verbally verified.  Three drops of tetracaine were applied to the operative eye.  The patient was then prepped and draped in usual sterile fashion for intraocular surgery.  A lid speculum was placed.  Two paracentesis sites were created approximately 120 degrees apart straddling the temple using a slit knife.  The anterior chamber was irrigated with a dilute 0.25% solution of non-preserved lidocaine and filled with Viscoat.  The clear corneal temporal incision was fashioned.  The anterior chamber was entered by introducing a keratome.  The continuous tear capsulorrhexis was performed using the bent needle cystotome and completed with Utrata forceps.  The cataractous lens was then hydrodissected and phacoemulsified using a modified phaco-chop technique.  Following removal of the last nuclear quadrant, there was noted to be a posterior capsular hole nasally.  This area was tamponaded with Healon.  The anterior chamber was swept with a cyclodialysis spatula and there was noted to be vitreous prolapse.  An anterior vitrectomy was then performed bimanually until the vitreous was cleared from the anterior chamber area.  The sulcus area of the lens was then inflated using Healon and a V9002 16.0 diopter intraocular lens was unfolded and centered in the sulcus area with haptic secured in the sulcus.  There was noted to be good support.  Miostat was injected into the anterior chamber and viscoelastic agent rinsed out of the eye with Miostat.  Gentle bimanual irrigation, aspiration was performed to remove remaining viscoelastic agents anteriorly.  The pupil was noted to constrict symmetrically.  Wounds were checked with Weck-cels and found to be free of vitreous.  BSS was used to re-inflate the anterior chamber to normal depth as confirmed by tactile pressure at about 12.  All corneal wounds were then hydrated, checked and found to be watertight and free of vitreous.  A single 10-0 nylon suture was placed temporarily as prophylaxis and the knot buried.  Lid speculum was removed.  TobraDex ointment, light patch and a Soft Shield were applied.  The patient was taken to the recovery room, awake and comfortable.  We will follow up in the morning for postoperative check.  He will not be given Diamox due to his sulfa allergy.  The intraoperative course was discussed with both he and his wife.ophthalmology, intraocular lens implant, lid speculum, cataract extraction, anterior vitrectomy, anterior chamber, eye, intraocular, extraction, hemodynamic, implant, vitrectomy, vitreous, cataract, lens,
Conjunctivitis 

CONJUNCTIVITIS,, better known as Pink Eye, is an infection of the inside of your eyelid.  It is usually caused by allergies, bacteria, viruses, or chemicals.,WHAT ARE THE SIGNS AND SYMPTOMS?,1.  Red, irritated eye.,2.  Some burning and/or scratchy feeling.,3.  There may be a purulent (pus) or a mucous type discharge.,HOW IS IT TREATED?,It depends on what caused the Pink Eye.  It may or may not need medication for treatment.  If medication is given, follow the directions on the label.,TO PREVENT THE SPREAD OF THE INFECTION:,1.  Wash hands thoroughly before you use the medicine in your eyes.  After using the medicine in your eyes.  Every time you touch your eyes or face.,2.  Wash any clothing touched by infected eyes.,Clothes,Towels,Pillowcases,3.  Do not share make-up.  If the infection is caused by bacteria or a virus you must throw away your used make-up and buy new make-up.,4.  Do not touch the infected eye because the infection will spread to the good eye.  IMPORTANT!!!,5.  Pink Eye Spreads Very Easily!ophthalmology, eyelid, infected eyes, pink eye, conjunctivitis, eyes, infection, eye
Cataract Surgery 

NORMAL CATARACT SURGERY,PROCEDURE DETAILS: , The patient was taken to the operating room where the Rand-Stein anesthesia protocol was followed using alfentanil and Brevital.  Topical tetracaine drops were applied.  The operative eye was prepped and draped in the usual sterile fashion.  A lid speculum was inserted.,Under the Zeiss operating microscope, a lateral clear corneal approach was utilized.  A stab incision was made with a diamond blade to the right of the lateral limbus and the anterior chamber filled with intracameral lidocaine and viscoelastic.  A 3-mm single pass clear corneal incision was made just anterior to the vascular arcade of the temporal limbus using a diamond keratome.  A 5- to 5.5-mm anterior capsulorrhexis was created.  The nucleus was hydrodissected and hydrodelineated, and was freely movable in the capsular bag.  The nucleus was then phacoemulsified using a quadrantic divide-and-conquer technique.  Following the deep groove formation, the lens was split bimanually and the resultant quadrants and epicortex removed under high-vacuum burst-mode phacoemulsification.  Peripheral cortex was removed with the irrigation and aspiration handpiece.  The posterior capsule was polished.  The capsular bag was expanded with viscoelastic.  The implant was inspected under the microscope and found to be free of defects.  The implant was inserted into the cartridge system under viscoelastic and placed in the capsular bag.  The trailing haptic was positioned with the cartridge system.  Residual viscoelastic was removed from the anterior chamber and from behind the implant.  The corneal wound was hydrated with balanced salt solution.  The anterior chamber was fully re-formed through the side-port incision.  The wound was inspected and found to be watertight.  The intraocular pressure was adjusted as necessary.  The lid speculum was removed.  Topical Timoptic drops, Eserine and Dexacidin ointment were applied.  The eye was shielded.  The patient appeared to tolerate the procedure well and left the operating room in stable condition.  Followup appointment is with Dr. X on the first postoperative day.ophthalmology, zeiss, peripheral cortex, phacoemulsified, hydrodissected, rand-stein, lid speculum, anterior chamber, capsular bag, cataract, viscoelasticNOTE,: Thesetranscribed medical transcription sample reports and examples are provided by various users andare for reference purpose only. MTHelpLine does not certify accuracy and quality of sample reports.These transcribed medical transcription sample reports may include some uncommon or unusual formats;this would be due to the preference of the dictating physician. All names and dates have beenchanged (or removed) to keep confidentiality. Any resemblance of any type of name or date orplace or anything else to real world is purely incidental.,
Connective Tissue Disorder 

Her past medical history includes a presumed diagnosis of connective tissue disorder.  She has otherwise, good health.  She underwent a shoulder ligament repair for joint laxity.,She does not take any eye medications and she takes Seasonale systemically.  She is allergic to penicillin.,The visual acuity today, distance with her current prescription was 20/30 on the right and 20/20 on the left eye.  Over refraction on the right eye showed -0.50 sphere with acuity of 20/20 OD.  She is wearing -3.75 +1.50 x 060 on the right and -2.50 +0.25 x 140, OS.  Intraocular pressures are 13 OU and by applanation.  Confrontation, visual fields, extraocular movement, and pupils are normal in both eyes.  Gonioscopy showed normal anterior segment angle morphology in both eyes.  She does have some fine iris strength crossing the angle, but the angle is otherwise open 360 degrees in both eyes.,The lids were normal in both eyes.  Conjunctivae were quite, OU.  Cornea were clear in both eyes.  The anterior chamber is deep and quiet, OU.  She has clear lenses, which are in good position, OU.  Dilated fundus exam shows moderately optically clear vitreous, OU.  The optic nerves are normal in size.  The cup-to-disc ratios were approximately 0.4, OU.  The nerve fiber layers are excellent, OU.  The macula, vessels, and periphery were normal in both eyes.  No evidence of peripheral retinal degeneration is present in either eye.,Ms. ABC has optically clear vitreous.  She does not have any obvious risk factors for retinal detachment at present such as peripheral retinal degeneration and her anterior chamber angles are normal in both eyes.,She does have moderate myopia, however.,This combination of findings suggests and is consistent with her systemic connective tissue disorder such as a Stickler syndrome or a variant of Stickler syndrome.,I discussed with her the symptoms of retinal detachment and advised her to contact us immediately if they occur.  Otherwise, I can see her in 1 to 2 years.ophthalmology, systemic connective tissue disorder, stickler syndrome, anterior chamber angles, retinal degeneration, connective tissue disorder, vitreous, degeneration, detachment, myopia, optically, astigmatism, eyes
Cataract Extraction Followup 

Her past medical history includes insulin requiring diabetes mellitus for the past 28 years.  She also has a history of gastritis and currently is being evaluated for inflammatory bowel disease.  She is scheduled to see a gastroenterologist in the near future.  She is taking Econopred 8 times a day to the right eye and Nevanac, OD, three times a day.  She is allergic to penicillin.,The visual acuity today was 20/50, pinholing, no improvement in the right eye.  In the left eye, the visual acuity was 20/80, pinholing, no improvement.  The intraocular pressure was 14, OD and 9, OS.  Anterior segment exam shows normal lids, OU.  The conjunctiva is quiet in the right eye.  In the left eye, she has an area of sectoral scleral hyperemia superonasally in the left eye.  The cornea on the right eye shows a paracentral area of mild corneal edema.  In the left eye, cornea is clear.  Anterior chamber in the right eye shows trace cell.  In the left eye, the anterior chamber is deep and quiet.  She has a posterior chamber intraocular lens, well centered and in sulcus of the left eye.  The lens in the left eye shows 3+ nuclear sclerosis.  Vitreous is clear in both eyes.  The optic nerves appear healthy in color and normal in size with cup-to-disc ratio of approximately 0.48.  The maculae are flat in both eyes.  The retinal periphery is flat in both eyes.,Ms. ABC is recovering well from her cataract operation in the right eye with residual corneal swelling, which should resolve in the next 2 to 3 weeks.  She will continue her current drops.  In the left eye, she has an area of what appears to be sectoral scleritis.  I did a comprehensive review of systems today and she reports no changes in her pulmonary, dermatologic, neurologic, gastroenterologic or musculoskeletal systems.  She is, however, being evaluated for inflammatory bowel disease.  The mild scleritis in the left eye may be a manifestation of this.  We will notify her gastroenterologist of this possibility of scleritis and will start Ms. ABC on a course of indomethacin 25 mg by mouth two times a day.  I will see her again in one week.  She will check with her primary physician prior to starting the Indocin.ophthalmology, visual acuity, photophobia, lens implant, cataract extraction, eye, cataract, cornealNOTE,: Thesetranscribed medical transcription sample reports and examples are provided by various users andare for reference purpose only. MTHelpLine does not certify accuracy and quality of sample reports.These transcribed medical transcription sample reports may include some uncommon or unusual formats;this would be due to the preference of the dictating physician. All names and dates have beenchanged (or removed) to keep confidentiality. Any resemblance of any type of name or date orplace or anything else to real world is purely incidental.
Cataract Extraction - 1 

PROCEDURE PERFORMED: , Extracapsular cataract extraction with posterior chamber intraocular lens placement by phacoemulsification.,ANESTHESIA:,  Peribulbar.,COMPLICATIONS:,  None.,DESCRIPTION OF PROCEDURE:  ,The patient was brought to the operating room after the eye was dilated with topical Mydriacyl and Neo-Synephrine drops.  A Honan balloon was placed over the eye for a period of 20 minutes at 10 mmHg.  A peribulbar block was given to the eye using 8 cc of a mixture of 0.5% Marcaine without epinephrine mixed with Wydase plus one-half of 2% lidocaine without epinephrine.  The Honan balloon was then re-placed over the eye for an additional 10 minutes at 20 mmHg.  The eye was prepped with a Betadine solution and draped in the usual sterile fashion.  A wire speculum was placed in the eye and then a clear corneal paracentesis site was made inferiorly with a 15-degree blade, followed by instillation of 0.1 cc of preservative-free lidocaine 1% into the anterior chamber, followed by viscoelastic.  A 2.8-mm keratome was used to create a self-sealing temporal corneal incision and then a bent capsulotomy needle was used to create an anterior capsular flap.  The Utrata forceps were used to complete a continuous tear capsulorrhexis, and hydrodissection and hydrodelineation of the nucleus was performed with BSS on a cannula.  Phacoemulsification in a quartering-and-cracking technique was used to remove the nucleus and then the residual cortex was removed with the irrigation and aspiration unit.  Gentle vacuuming of the central posterior capsule was performed.  The capsular bag was re-expanded with viscoelastic, and then the wound was opened to a 3.4-mm size with an additional keratome to allow insertion of the intraocular lens.,The intraocular lens was folded, inserted into the capsular bag and then un-folded.  The trailing haptic was tucked underneath the anterior capsular rim.  The lens was shown to center very well.  Therefore, the viscoelastic was removed with the irrigation and aspiration unit and one 10-0 nylon suture was placed across the incision after Miochol was injected into the anterior chamber to cause pupillary constriction.  The wound was shown to be watertight.  Therefore, TobraDex ointment was applied to the eye, an eye pad loosely applied and a Fox shield taped firmly in place.,The patient tolerated the procedure well and left the operating room in good condition.ophthalmology, phacoemulsification, hydrodissection, peribulbar block, irrigation and aspiration, honan balloon, anterior chamber, anterior capsular, aspiration unit, capsular bag, cataract extraction, intraocular lens, cataract, extraction, peribulbar, lidocaine, viscoelastic, chamber, epinephrine, anterior, capsular, lens, intraocular, eye,
Cataract Extraction 

PROCEDURE PERFORMED:,  Cataract extraction with lens implantation, right eye.,DESCRIPTION OF PROCEDURE: , The patient was brought to the operating room.  The patient was identified and the correct operative site was also identified.  A retrobulbar block using 5 ml of 2% lidocaine without epinephrine was done after adequate anesthetic was assured, and the eye was massaged to reduce risk of bleeding.  The patient was prepped and draped in the usual fashion.  A lid speculum was applied.,A groove incision at the 12 o'clock position was made with a 5700 blade.  This was beveled anteriorly in a lamellar fashion using the crescent knife.  Then the anterior chamber was entered with a slit knife.  The chamber was deepened with Viscoat.  Then a paracentesis at the 3 o'clock position was created using a super sharp blade.  A cystitome was used to nick the anterior capsule and then the capsulotomy was completed with capsulorrhexis forceps.  Hydrodissection was employed using BSS on a blunt 27-gauge needle.,The phaco tip was then introduced into the eye, and the eye was divided into 4 grooves.  Then a second instrument was used, a Sinskey hook, to crack these grooves, and the individual quadrants were brought into the central zone and phacoemulsified.  I/A proceeded without difficulty using the irrigation/aspiration cannula.  The capsule was felt to be clear and intact.  The capsular bag was then expanded with ProVisc.,The internal corneal wound was increased using the slit knife.  The lens was inspected and found to be free of defects, folded, and easily inserted into the capsular bag, and unfolded.  A corneal light shield was then used as the wound was sutured with a figure-of-eight 10-0 nylon suture.  Then the Viscoat was removed using I/A, and the suture drawn up and tied.,The 0.2 ml of gentamicin was injected subconjunctivally.  Maxitrol ointment was instilled into the conjunctival sac.  The eye was covered with a double patch and shield, and the patient was discharged.ophthalmology, lens implantation, anterior chamber, lid speculum, eye, sinskey hook, cataract extraction, capsular bag, cataract, capsular, knife, lens
Cataract Extraction - 2 

PREOPERATIVE DIAGNOSIS: , Cataract, left eye.,POSTOPERATIVE DIAGNOSIS:  ,Cataract, left eye.,PROCEDURE PERFORMED:  ,Extracapsular cataract extraction with phacoemulsification and implantation of a posterior chamber intraocular lens, left eye.,ANESTHESIA: , Topical.,COMPLICATIONS: , None.,PROCEDURE: , After the induction of topical anesthesia with 4% Xylocaine drops, the left eye was prepped and draped in the usual fashion.  A speculum was inserted, and the microscope was moved into position.,A 3.2-mm incision was made in clear cornea at the limbus with a diamond keratome at the 3 o'clock position, and 0.1 cc of 1% Xylocaine without preservative was instilled into the anterior chamber.  It was then filled with viscoelastic.  A stab incision was made into the anterior chamber at the limbus at 5 o'clock position with a microblade.,A cystitome was used to make a capsulotomy, and the capsulorrhexis forceps were used to complete a circular capsulorrhexis.  The nucleus was hydrodelineated and hydrodissected with balanced salt solution on a 26-gauge cannula, and the phacoemulsifier was used to phacoemulsify the nucleus using a bimanual technique with the nucleus rotator inserted through the keratotomy incision.  The irrigation-aspiration handpiece was used to systematically aspirate cortex 360 degrees.  The posterior capsule was vacuumed; it was clear and intact.,The capsular bag and the anterior chamber were filled with viscoelastic.  A model MA30AC lens, power 21.5 diopters, serial number 864414.095, was folded, grasped with the lens insertion forceps and inserted into the capsular bag.  The trailing loop was placed inside the bag.  The viscoelastic was removed with the irrigation-aspiration handpiece.  The lens centered well.  A single 10-0 nylon suture was placed to close the wound.  It was checked and ascertained to be watertight.  Decadron 0.25 cc, 0.25 cc of antibiotic and 0.25 cc of Xylocaine were injected subconjunctivally.  Dexacidin ointment was placed in the eye, and the procedure was terminated.,The procedure was well tolerated by the patient who was returned to the recovery room in good condition.ophthalmology, anterior chamber, keratome, limbus, intraocular lens, cataract extraction, extracapsular, phacoemulsification, capsular, cataract, chamber, intraocular,
Blepharoplasty - Quad 

PREOPERATIVE DIAGNOSES:,1.  Blepharochalasia.,2.  Lower lid large primary and secondary bagging.,POSTOPERATIVE DIAGNOSES:,1.  Blepharochalasia.,2.  Lower lid large primary and secondary bagging.,PROCEDURE: , Quad blepharoplasty.,ANESTHESIA: , General.,ESTIMATED BLOOD LOSS: , Minimal.,CONDITION: , The patient did well.,PROCEDURE:  ,The patient had marks and measurements prior to surgery.  Additional marks and measurements were made at the time of surgery; these were again checked.  At this point, the area was injected with 0.5% lidocaine with 1:200,000 epinephrine.  Appropriate time waited for the anesthetic and epinephrine effect.,Beginning on the left upper lid, the skin excision was completed.  The muscle was opened, herniated, adipose tissue pad in the middle and medial aspect was brought forward, cross-clamped, excised, cauterized, and allowed to retract.  The eyes were kept irrigated and protected throughout the procedure.  Attention was turned to the opposite side.  Procedure was carried out in the similar manner.,At the completion, the wounds were then closed with a running 6-0 Prolene, skin adhesives, and Steri-Strips.  Attention was turned to the right lower lid.  A lash line incision was made.  A skin flap was elevated and the muscle was opened.  Large herniated adipose tissue pads were present in each of the three compartments.  They were individually elevated, cross-clamped, excised, cauterized, and allowed to retract.,At the completion, a gentle tension was placed on the facial skin and several millimeters of the skin excised.  Attention was turned to he opposite side.  The procedure was carried out as just described.  The contralateral side was reexamined and irrigated.  Hemostasis was good and it was closed with a running 6-0 Prolene.  The opposite side was closed in a similar manner.,Skin adhesives and Steri-Strips were applied.  The eyes were again irrigated and cool Swiss Eye compresses applied.  At the completion of the case, the patient was extubated in the operating room, breathing on her own, doing well, and transferred in good condition from operating room to recovering room.ophthalmology, blepharochalasia, lower lid, swiss eye compresses, adipose tissue pad, bagging, blepharoplasty, lash line incision, quad blepharoplasty,