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Anesthesia for emergent eye surgery

Authors
Alvaro A Macias, MD
Joseph Bayes, MD
Kathryn E McGoldrick, MD, FCAI(Hon)
Section Editor
Girish P Joshi, MB, BS, MD, FFARCSI
Deputy Editor
Nancy A Nussmeier, MD, FAHA

INTRODUCTION

Anesthetic management of patients presenting for urgent or emergent eye surgery after penetrating eye injury is challenging primarily because of the risk of extrusion of ocular contents if intraocular pressure becomes elevated. Additional concerns include risk of aspiration in patients with a full stomach, and the possibility of associated traumatic injuries (eg, orbital or cranial trauma).

A foreign body in the eye is the most common type of eye trauma, accounting for 35 percent of all eye injuries. Open wounds and contusions each account for about 25 percent of injuries, and the remainder are burns. Nearly 35 percent of eye injuries occur in patients ≤17 years old. Although eye injury is not a significant cause of total blindness, it is the most common cause of monocular blindness.

The anesthetic management of patients undergoing elective eye surgery is discussed separately. Emergency and surgical management of specific eye injuries, including open globe injury, conjunctival injury, traumatic hyphema, and retinal detachment, are discussed in other topics. (See "Approach to eye injuries in the emergency department" and "Open globe injuries: Emergent evaluation and initial management" and "Traumatic hyphema: Management" and "Conjunctival injury" and "Anesthesia for elective eye surgery" and "Cataract in adults".)

PREOPERATIVE ASSESSMENT

During the preoperative assessment, the anesthesiologist should determine [1]:

The mechanism of eye trauma, and the possibility of associated traumatic injuries (eg, orbital and/or skull fractures, subdural hematoma, or intracranial trauma).

                

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Literature review current through: Nov 2016. | This topic last updated: Thu Jan 07 00:00:00 GMT+00:00 2016.
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