Summary
Examinations under anesthesia are required when a child cannot be adequately examined in the eye clinic for potentially vision-threatening eye disease. Additional testing may also be indicated while the patient is sedated.
19 Preparations for Examinations under Anesthesia
19.1 Goals
Obtaining as complete an examination as possible while the patient is sedated.
19.2 Advantages
An examination under anesthesia can provide the information needed for appropriate treatment planning in a patient who is otherwise unable to be adequately examined in the clinic.
19.3 Expectations
Adequate anesthesia to complete the eye examination and any additional planned testing. Strabismus cannot be accurately evaluated while the patient is under anesthesia, but forced duction testing may be performed.
19.4 Key Principles and Preoperative Preparation
Determine the elements of the examination and testing needed during the examination under anesthesia when planning and scheduling the case. If possible and if needed for the patient’s examination, instill dilating eye drops preoperatively to decrease the time under anesthesia.
19.5 Indications
Potentially vision-threatening eye disease that cannot be adequately evaluated in the office due to lack of cooperation, or which requires testing that will not be tolerated by the patient while awake.
19.6 Contraindications
Some patients whose examinations are limited in the office may have underlying systemic disease that put them at greater anesthesia risk. The indications for the examination under anesthesia should be discussed with the patient’s family, pediatrician, as well as the anesthesia team.
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