23/10/2025
Describe about Ocular Anesthesia ?
⭐ Definition:
Ocular anesthesia refers to the loss of sensation (mainly pain) in the eye or its surrounding structures, induced intentionally before performing ophthalmic procedures or surgeries. It helps in preventing pain, reducing anxiety, and controlling eye movement during operations.
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⭐Types of Ocular Anesthesia
✨1. Topical Anesthesia
👉Definition: Anesthetic eye drops are used to numb the surface of the eye.
👉Drugs used:
👍Proparacaine (0.5%)
👍Tetracaine (0.5%)
👍Lidocaine (2%) drops
⭐Uses:
👉Tonometry
👉Foreign body removal
👉Small corneal procedures
👉Cataract surgery (in cooperative patients)
⭐Advantages:
👉Painless and easy to apply
👉No needle or injection needed
⭐Disadvantages:
No effect on eye movement
Short duration of action
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✨2. Infiltrative (Injection) Anesthesia
✅a. Retrobulbar Block
Injection site: Behind the eyeball (retrobulbar space)
Drugs used: Lignocaine with or without Bupivacaine
Effect: Anesthetizes the globe and extraocular muscles (akinesia)
Used in: Intraocular surgeries like cataract or glaucoma operations
✅b. Peribulbar Block
Injection site: Around the eyeball but outside the muscle cone
Effect: Produces anesthesia with less risk of optic nerve injury
Advantage: Safer than retrobulbar block
✅c. Sub-Tenon’s Block
Injection site: Between Tenon’s capsule and sclera
Used in: Cataract and vitreo-retinal surgeries
Advantage: Minimal complications
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✨3. General Anesthesia
Definition: The patient is made completely unconscious using inhaled or intravenous anesthetics.
Used in:
Children or uncooperative patients
Long and complex surgeries (e.g., orbital tumors, trauma)
Drugs used: Propofol, Sevoflurane, etc.
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⭐Complications
👉Hemorrhage (retrobulbar or peribulbar)
👉Globe perforation
👉Ptosis or diplopia
👉Optic nerve injury
👉Systemic toxicity (if drug enters bloodstream)
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👍Summary Table :-
Type-- Route-- Effect on Eye Movement-- Common Use
Topical --Drops-- No --Minor surface procedures
Retrobulbar --Behind globe-- Yes-- Cataract, glaucoma surgery
Peribulbar-- Around globe-- Yes-- Intraocular surgeries.
Sub-Tenon’s --Between Tenon’s & sclera-- Yes --Cataract, VR surgeries
General-- Systemic --Yes Long/complex surgeries, children
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