Anaesthesia for strabismus, cataract, and glaucoma surgery

Meet the patient

Your morning list is three patients and three completely different anaesthetics. First, a four-year-old for bilateral medial rectus recession. Then an 82-year-old for cataract under sub-Tenon block, on tamsulosin and with ischaemic heart disease. Last, a trabeculectomy under general anaesthesia because the patient cannot lie still.^[5]

The examiner's discriminator is whether you change the plan when the eye operation changes. Strabismus equals OCR plus PONV, cataract equals topical or sub-Tenon with medical comorbidity, glaucoma equals IOP stability — run the same recipe for all three and you fail the topic.^[4][5]

References5ShowHide

1. [1]Martyn JA, Richtsfeld M Succinylcholine-induced hyperkalemia in acquired pathologic states: etiologic factors and molecular mechanisms Anesthesiology, 2006.PMID 16394702
2. [2]Devereaux PJ, Yang H, Yusuf S, et al. Effects of extended-release metoprolol succinate in patients undergoing non-cardiac surgery (POISE trial): a randomised controlled trial Lancet, 2008.PMID 18479744
3. [3]Lee TH, Marcantonio ER, Mangione CM, et al. Derivation and prospective validation of a simple index for prediction of cardiac risk of major noncardiac surgery Circulation, 1999.PMID 10477528
4. [4]Arnold RW The Oculocardiac Reflex: A Review. Clin Ophthalmol, 2021.PMID 34194223
5. [5]Pucchio A, Pur DR, Dhawan A, et al. Anesthesia for ophthalmic surgery: an educational review. Int Ophthalmol, 2023.PMID 36436168