1/3. The ophthalmological assessment of the severely retarded child.This paper details the technique for ocular assessment of the severely retarded child including the use of electrophysiological methods of examination and monitored dissociated anaesthesia. This examination is conducted in the child's hospital residential school environment. Analysis of these assessments shows a high incidence of pathological defects, strabismus, nystagmus, cataract and refractive errors. These findings are similar to the experience of an overseas clinic. A plea is made for early ocular examination in the first year of life in the suspected neonate to help establish a general diagnosis, prepare a plan of management and prevent secondary retardation.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
2/3. Penetrating eye injury from a rigid infant pacifier.BACKGROUND: The use of infant pacifiers (dummies) is common in Australasian communities and has been reported to be associated with various injuries, but to date ocular trauma has not been reported. CASE REPORT: A 14-month-old child sustained a penetrating eye injury from the infant pacifier that was in his mouth during a minor fall. Only a lid laceration was detected at the time. One week later he presented with mydriasis, heterochromia and a poor red reflex. diagnosis of a penetrating eye injury was made by examination under anaesthesia, with B-scan ultrasonography demonstrating hypotony but no retinal detachment or intraocular foreign body. Funduscopy revealed a small inferior vitreous haemorrhage. Exploration of the globe adjacent to the lid wound showed a 6 mm laceration through the sclera plugged with prolapsed vitreous. CONCLUSION: Serious ocular injury may result after a minor fall with some designs of rigid infant pacifiers. Heterochromia and anisocoria noted by the mother heralded more serious ocular injury in this case. The delay in diagnosis of this injury emphasizes the importance of ocular examination to exclude eye trauma when injuries occur around the orbit.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
3/3. A complication of peribulbar block in a patient with exophthalmos.A patient with marked exophthalmos secondary to thyroid eye disease presented for tarsorrhaphy and removal of orbital fat. A single superolateral peribulbar injection was performed. After injection of 3.5 ml of local anaesthetic solution, the globe suddenly dislocated anteriorly. This complication has not been described previously. In patients with exophthalmos, general anaesthesia should be considered as the method of choice for ophthalmic procedures.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |