Pre – Operative Evaluation & Preparation Sr. Vimala Aravind Eye Hospital, Coimbatore

Why it is IMPORTANT ?  Eye surgeries are done under very strict aseptic precaution.  Any compromise may cause sight threatening disaster.  Hence Pre-operative evaluation & preparation is very important in eye surgeries.

Pre – Operative Evaluation  Visual acuity – distant and near [ in all mature cataract – PL & PR ]  Retinoscopy  Slit lamp Examination  Dilated fundus Examination

 Intraocular Pressure  Duct Not Free - Culture Partially free, Free – No culture

 Any pustules, Chalazion, Conjunctival congestion, discharge, lid hygiene  If present, appropriate treatment, culture and sensitivity

Pre operative medications  Antibiotic eye drops 1 hourly  Mydriatic eye drop  Tab Diazepam/Tab Alprax

 If one eyed – all precautions to be taken including culture and sensitivity  Other eye status – any active infections to be ruled out

Cardio Vascular System Respiratory System DM Diabetic foot ulcer Skin infection, dental caries, eardischarge General examination

 Conjunctiva  Cornea : opacity,degeneration,dystrophy,guttae  AC : depth / reaction  Iris : synechiae,coloboma,PXF  Pupil : Reaction -if irregular, suspect posterior synechiae,poor dilatation - PXF SLIT LAMP EXAMINATION

 Lens : type of cataract,subluxation  Fundus : after full dilatation to R/o Diabetic / HTN Retinopathy / ARMD etc to explain  the visual prognosis.

 Urine Investigation  Urine sugars  Blood investigation  Blood sugars – RBS  If diabetic Fasting Post Prandial

 Blood pressure  Povidone iodine cleaning of the periorbital area.  A – Scan biometry

SPECIAL TESTS  B scan : Complicated / Traumatic / MC Miopia,MC with RD in other eye PR inaccurate IOFB TO EXPLAIN ABOUT VISUAL PROGNOSIS

Pre-op Preparation