Pediatric ophthalmic indications for examination under anesthesia in Ilorin, Nigeria

Mahmoud, Abdulraheem O; Ayanniyi, Abdulkabir Ayansiji; Oyedepo, Olanrewaju Olubukola

doi:10.4103/1596-3519.68357

Cited by 5 publications

(4 citation statements)

References 8 publications

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“…The red reflex exam and cycloplegic retinoscopy, if tolerated, are most helpful in evaluating the visual significance of cataracts in nonverbal patients, as many cannot participate in a slit lamp examination in the clinic. In situations where clinic exams cannot be completed, exams under anesthesia may need to be utilized [14]. Furthermore, there is a higher incidence of difficulty wearing glasses, patching, and cooperating during clinical examination in nonverbal patients compared to verbal patients with DD.…”

Section: Discussionmentioning

confidence: 99%

Management of Cataracts in Pediatric Patients with Developmental Delay at a Tertiary Care Pediatric Hospital

Panneerselvam¹,

Chilakapati²,

Moisiuc³

et al. 2021

OJOph

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Background: Childhood cataract causing visual impairment can compound developmental delay (DD) if left untreated. Current literature in children with DD is limited; thus, we evaluated cataract etiology, challenges, and treatment compliance in this group. Purpose: To report the presentation and challenges associated with cataract management in children with developmental delay (DD) at a tertiary care pediatric hospital. Methods: Retrospective review of 100 patients (173 eyes) presenting with cataracts and DD from February 2014 to December 2017. Results: 100 patients (173 eyes) were included. 27 patients had unilateral cataracts and 73 bilateral. The average age was 120.55 months (SD 63.77, range 5.87 -243.16); the average follow-up period was 57.7 months (SD 139.14, range 1.03 -1412.30). 61% of patients (55% eyes) underwent medical management for cataracts due to: cataract was not visually significant (66% eyes), parent deferred surgery (11% eyes), self-abusive behavior (14% eyes), and medical conditions that limited visual recovery (9% eyes). 32% of patients were unable to perform objective visual acuity by age 5. Patients with self-abusive behavior were more likely to present with or develop retinal detachment (RD) (35%) compared to those without self-abusive behavior (6%) (p = 0.0028). A statistically significant difference in the difficulty of examination (p < 0.0001) and poor compliance of glasses wear (p < 0.0001) was found in nonverbal patients. Surgical complications occurred in 39% of eyes. Those with intraocular lens placement after cataract extraction were more likely to develop visual axis opacification (27% eyes) than those who remained aphakic (9% eyes) (p = 0.0313). Conclusion: Cataract extraction in pediatric patients with DD can be associated with success, however, providers should prepare for limitations in managing these patients.

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Section: Discussionmentioning

confidence: 99%

Management of Cataracts in Pediatric Patients with Developmental Delay at a Tertiary Care Pediatric Hospital

Panneerselvam¹,

Chilakapati²,

Moisiuc³

et al. 2021

OJOph

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“…Pediatric ocular examinations in an office can be incomplete when dealing with very young children, those with special needs, and with complex problems. [ 1 ] The various common indications for EUA are enlisted in Table 1 .…”

Section: Indications For Examination Under Anesthesiamentioning

confidence: 99%

“…Anesthesia is needed for small procedures such as suture removal or diagnostic procedures like applanation tonometry, gonioscopy, detailed fundus examination, anterior and posterior segment imaging, and electrophysiological tests. [ 1 ] It can be a part of surgery to record baseline parameters which are also the part of postoperative follow-up regime.…”

mentioning

confidence: 99%

Examination under anesthesia: Preferred Practice

Dhillon,

Agarkar,

Vijaya1

et al. 2023

Indian Journal of Ophthalmology

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Pediatric ocular examinations are often a challenge in the outpatient setting due to limited cooperation of the child. Hence an evaluation under anesthesia (EUA) or sedation is important for a holistic ophthalmic examination. It can be combined with short procedures, such as suture removal and corneal scrappings, both for diagnosis and for the management of several ophthalmic disorders. It can also be performed before planning a surgical intervention to record the baseline characters and formulate or refine a surgical plan. Every EUA must be used as a chance to perform a complete ophthalmic examination rather than perform a single task such as recording the intraocular pressure. This article aims to provide a protocol that can be followed for a complete EUA.

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“…For example, in Ilorin, Nigeria a retrospective study of 39 children underwent EUAs without IV access during an 18-year period. Of this group, 36 children (92.3%) had inhalational anesthesia administered as the anesthetic of choice,5 thus providing initial evidence of common practice utilizing inhalational anesthesia in the African continent.…”

Section: Introductionmentioning

confidence: 99%

Can children undergoing ophthalmologic examinations under anesthesia be safely anesthetized without using an IV line?

Vigoda

Latiff

Murray

et al. 2011

OPTH

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Purpose:To document that with proper patient and procedure selection, children undergoing general inhalational anesthesia for ophthalmologic exams (with or without photos, ultrasound, laser treatment, peri-ocular injection of chemotherapy, suture removal, and/or replacement of ocular prosthesis) can be safely anesthetized without the use of an intravenous (IV) line. Children are rarely anesthetized without IV access placement. We performed a retrospective study to determine our incidence of IV access placement during examinations under anesthesia (EUA) and the incidence of adverse events that required intraoperative IV access placement.Methods:Data collected from our operating room (OR) information system includes but is not limited to diagnosis, anesthesiologist, surgeon, and location of IV catheter (if applicable), patient’s date of birth, actual procedure, and anesthesia/procedure times. We reviewed the OR and anesthetic records of children (>1 month and <10 years) who underwent EUAs between January 1, 2003 and May 31, 2009. We determined the percentage of children who were anesthetized without IV access placement, as well as the incidence of any adverse events that required IV access placement, intraoperatively.Results:We analyzed data from 3196 procedures performed during a 77-month period. Patients’ ages ranged from 1 month to 9 years. Overall, 92% of procedures were performed without IV access placement. Procedure duration ranged from 1–39 minutes. Reasons for IV access placement included parental preference for antinausea medication and/or attending preference for IV access placement. No child who underwent anesthesia without an IV line had an intraoperative adverse event requiring insertion of an IV line.Conclusion:Our data suggest that for children undergoing general anesthesia for ophthalmologic exams (with or without photos, ultrasound, laser treatment, intraocular injection of chemotherapy, suture removal, and/or replacement of ocular prosthesis), anesthesia can be safely conducted without placement of an IV line.

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Pediatric ophthalmic indications for examination under anesthesia in Ilorin, Nigeria

Cited by 5 publications

References 8 publications

Management of Cataracts in Pediatric Patients with Developmental Delay at a Tertiary Care Pediatric Hospital

Management of Cataracts in Pediatric Patients with Developmental Delay at a Tertiary Care Pediatric Hospital

Examination under anesthesia: Preferred Practice

Can children undergoing ophthalmologic examinations under anesthesia be safely anesthetized without using an IV line?

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