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Ophthalmic surgeries utilize various anaesthesia modalities based on the type of surgery, patient health, and preferences. The primary types include:

  1. Topical Anaesthesia: It is a relatively fast and simple technique that provides superficial anaesthesia without the potential hazards of injections. Its use is limited to minor procedures and low complexity cases with adequate patient cooperation, as it does not provide complete akinesia or intraocular pressure control. Topical anaesthesia may be achieved using eye drop applications, gel application, or anaesthetic-impregnated sponge application that numb the surface of the eye, providing comfort while maintaining patient alertness. It's minimally invasive with a quick recovery.
  2. Local Anaesthesia: Involves injecting anaesthetics around the eye, such as peribulbar, subconjunctival, or sub-tenon blocks. This provides profound anaesthesia and akinesia (immobility) for more invasive surgeries, like glaucoma or vitreoretinal procedures.
  3. General Anaesthesia: Indicated for complex surgeries, patients with severe anxiety, children, or those unable to remain still. This method ensures complete unconsciousness and immobility, though it carries higher risks and requires more intensive monitoring.

Selection of anaesthesia is based on several factors:

  • Surgery Type: Minor surgeries often use topical or local anaesthesia, while major or lengthy procedures might need general anaesthesia.
  • Patient Condition: General health, age, and ability to cooperate influence the choice. For example, children often require general anaesthesia.
  • Surgeon Preference and Skill: Experience with specific anaesthesia techniques can dictate choice.
  • Patient Preference: When feasible, patient comfort and choice play a significant role.

Preoperative evaluation ensures the safest and most effective anaesthesia modality is selected for each individual patient.

Written by:
Dr. Magued Abadeer,
Specialist Anaesthesiologist