Anaesthesia for Ophthalmology Surgery: A Complete Guide for Medical Students and Practitioners

Ophthalmic surgeries demand precision not only from the surgeon but also from the anaesthesiologist. The eye is a delicate organ, richly innervated and highly sensitive, making anaesthetic management a critical aspect of successful outcomes. Whether it’s a simple cataract extraction or complex retinal surgery, the anaesthesia technique plays a vital role in ensuring patient comfort, immobility, and safety.

In this article, we’ll explore the principles, types, and considerations of anaesthesia for ophthalmology surgery, helping medical students and practitioners understand this specialized field in detail.

🌿 1. Main Goals

• Provide analgesia (pain relief)

• Ensure akinesia (no eye movement)

• Prevent oculocardiac reflex (OCR)

• Maintain stable intraocular pressure (IOP)

💉 2. Common Anaesthetic Techniques

🟢 Topical Anaesthesia

• Used in cataract surgeries (eye drops like lidocaine).

• Simple and needle-free, but doesn’t stop eye movement.

🟢 Peribulbar Block

• Injection around the eyeball (outside muscle cone).

• Provides good pain relief and eye stillness.

🟢 Retrobulbar Block

• Deeper injection inside the muscle cone.

• Fast, effective, but with higher complication risk.

🟢 Sub-Tenon’s Block

• Safer alternative using a blunt cannula.

• Ideal for elderly or high-risk patients.

🟢 General Anaesthesia

• For kids, anxious adults, or long surgeries.

• Avoid coughing and straining to prevent IOP spikes.

⚡ 3. Key Intraoperative Concerns

• Oculocardiac Reflex: sudden bradycardia during eye manipulation → treat with atropine.

• IOP Control: smooth induction, avoid coughing, and maintain normal CO₂ levels.

✅ 4. Postoperative Care

• Calm emergence to prevent eye injury.

• Manage pain, nausea, and provide eye protection.

🌟 Takeaway:
Ophthalmic anaesthesia is all about stability, precision, and safety. Choosing the right technique depends on the surgery type, patient profile, and teamwork between surgeon and anaesthesiologist.

For more concise anaesthesia notes and clinical tips, visit AnaesthesiaNotes.com.