Brain 7

Question 1

What is the most common eye complication in the perioperative period?

Answer 1

corneal abrasian

Question 2

Treatments for corneal abrasian includes

Answer 2

antibiotic drops & NSAIDs
patching the eye is not recommended

Question 3

What is the most common cause of perioperative vision loss?

Answer 3

ischemic optic neuropaty

Question 4

What procedure is the most common culprit for ischemic optic neuropathy?

Answer 4

spinal surgery in the prone position

Question 5

What are additional higher-risk procedures that can result in ischemic optic neuropathy resulting in loss of vision?

Answer 5

cardiac surgery with CBP & radical neck dissection

Question 6

The most common cause of central retinal artery occlusion (CRAO) is

Answer 6

external compression on the globe from improper head positioning in the prone position

Question 7

CRAO can be prevented by

Answer 7

avoiding the horseshoe headrest

Question 8

This surgery puts patients at risk for CRAO:

Answer 8

patients who receive nitrous oxide following retinal detachment surgery with intraocular gas bubble placement

Question 9

Signs and symptoms of corneal abrasion include

Answer 9

pain, foreign body sensation, photophobia, excessive tearing, conjunctival erythema, and diminished visual acuity

Question 10

Common etiologies of corneal abrasion include

Answer 10

corneal drying, reduced tear production during general anesthesia, direct trauma during anesthesia care or trauma that results from the patient rubbing his eyes following anesthetic emergence

Question 11

Corneal abrasion is diagnosed by

Answer 11

application of fluorescein stain to the patient’s eye; when examined with a cobalt blue penlight or slit lamp, the affected region will appear green

Question 12

Prevention of corneal abrasion includes

Answer 12

taping the eyelids closed prior to laryngoscopy (most effective preventative measure)
horizontal taping (instead of vertical taping)
protective eye goggles or gauze eye pads if patient not supine or head turned away

Question 13

In most cases, corneal abrasion is

Answer 13

self-limiting and symptoms resolve in 1-3 days

Question 14

Ocular perfusion pressure equation is

Answer 14

ocular perfusion pressure= MAP- intraocular pressure

Question 15

Patient risk factors for ischemic optic neuropathy include

Answer 15

male sex
obesity
diabetes
hypertension
smoking
old age
atherosclerosis

Question 16

Procedure risk factors for ischemic optic neuropathy include

Answer 16

prone position
use of Wilson frame
long duration of anesthesia
large blood loss
low ratio of colloid to crystalloid resuscitation
hypotension

Question 17

ION is a ____ problem whereas CRAO is a _________problem

Answer 17

nerve; vessel