Anaesthesia for Paediatric Eye Surgery

Resources

A question specifically on paediatric day case strabismus surgery appeared in the 2019 SAQ, yet was "answered so poorly" to the tune of a 52% pass rate.

With an updated BJA Education article on offer (see below), a question on this topic could well be next in the paediatric or ophthalmic CRQ pipeline.

Most paediatric ophthalmic patients are fit and well, although ophthalmic issues may relate to underlying congenital or metabolic syndromes

Almost all surgeries will require GA
Although most will be day cases, surgery in ex-prem infants or neonates may require overnight monitoring for apnoeas (following standard guidelines)

EUA	Extra-ocular	Intra-ocular
Fundoscopy	Squint (strabismus) surgery	Glaucoma surgery
IOP measurement (ketamine IM/IV)	Syringing of ducts	Congenital cataracts
Cardiac failure	Repeat IV contrast load within 7 days	Vitreoretinal surgery
		LASER or cryotherapy

Associated with difficult airway	Neuro-ocular-cutaneous disorders	Associated with cardio-respiratory disease
Mucopolysaccharidoses e.g. Hurler's syn.y	Sturge-Weber syn.	Down's syndrome
Craniosynostosis disorders e.g. Crouzon, Apert	Neurofibromatosis	Marfan's syndrome
Craniofacial disorders e.g. Treacher-Collins, Pierre-Robin	Tuberous sclerosis	Mitochondrial disorders e.g. Kearns-Sayre
Down's syndrome	Von Hippel-Lindau syndrome	Myotonic dystrophy
Stickler syndrome