Ophthalmic Anesthesia

Anesthesia during ophthalmic surgery is important for patient safety and comfort and a desirable surgical outcome. A thorough preoperative assessment can reduce/avoid intraoperative and postoperative complications. Sedation is often used as a supplement to topical, intraocular, and periocular anesthesia to reduce pain and anxiety. General anesthesia remains the technique of choice for pediatric patients and patients with whom communication may be difficult. Topical anesthesia may be useful for short surgeries performed in cooperative patients. A variety of regional blocks are available for ophthalmic anesthesia, including retrobulbar, peribulbar, medial canthal and sub-Tenon's. Facial blocks may provide supplementary motor blockade of the orbicularis oris muscle, particularly following retrobulbar injections. Ophthalmic anesthesia and surgery may result in alterations of IOP and production of neuro-ophthalmic reflexes. The complications of ophthalmic anesthesia can be sight- and, potentially, life-threatening.