Anaesthesia for ophthalmic surgery has always been challenging because the patients range across all ages, but the elderly are especially vulnerable. They have an increased morbidity and are often taking multiple drugs that make even anaesthesia for minor surgery more risky. No wonder there has been a shift in the delivery of anaesthesia towards regional techniques although general anaesthesia remains the technique of choice for many intermediate and most complex ophthalmic operations. Understanding the physiology of the eye, the relevant anatomy, and the ophthalmic drugs patients may receive, all have major influences on the choice of anaesthesia. This varies worldwide but the current preference is firmly in favour of local anaesthesia. A practising ophthalmic anaesthetist should be skilled in a range of different techniques to deal with the needs of different operations, operators, and, most importantly, patients.
JOTTINGS ON LOCAL ANAESTHESIA IN OPHTHALMIC SURGERY
