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Anaesthesia for paediatric ophthalmic surgery 

Anaesthesia for paediatric ophthalmic surgery
Chapter:
Anaesthesia for paediatric ophthalmic surgery
Author(s):

Jacqueine Tutiven

DOI:
10.1093/med/9780199591398.003.0060
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date: 28 May 2020

Introduction 198

Preoperative assessment 200

Retinopathy of prematurity/retinal detachments in infants 206

Electroretinography and multifocal electroretinography 210

Cataract surgery 212

Strabismus surgery 216

Emergency surgery and ophthalmic anaesthesia in the paediatric patient 219

Emergence delirium in children 220

Conclusion 221

Key reading 221

At birth, the eye measures close to three-quarters that of the adult eye, reaching adult size by 14 years of age. The posterior portion grows proportionately more than the anterior portion of the globe. Infants do not see as well as adults. Infant's psychophysical sensitivity to light, colour, and contrast are far below the comparable values in adults, especially between 1 and 4 months. Infant visual acuity is poor at birth. At birth, visual acuity (VA) is approximately 20/400 to 20/800. By 4 to 5 months infants are no longer ‘legally blind’ (e.g., 20/200). VA reaches 20/20 between 8 to 12 months and does not reach the adult value until at least 3 years. Visual acuity can not be measured accurately until the age of 3 months. The infant's sclera is thin, translucent, and bluish in colour. The cornea measures 10mm and the curvature of the eye eventually flattens out with growth. The newborn has a fully developed retina but the fovea is immature....

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