Prevention of Postoperative Vision Loss: A Case Study
Postoperative visual loss (POVL) after nonocular surgery is an infrequent, but destructive problem that has been associated with numerous types of surgeries and patient risk factors (Stoelting & Miller, 2007). Stoelting and Miller estimate the incidence of POVL from 1 in 60,965 to 1 in 125,234 for patients undergoing noncardiac, nonocular surgeries, from 0.06% to 0.113% in cardiac surgery patients with cardiopulmonary bypass and 0.09% of prone spine surgeries. The need to understand the causes of POVL and the preventative measures that can be taken to lessen the likelihood of vision loss occurring are implications for anesthesia providers and patients alike. Consequences of POVL not only involve the debilitating impact on the patient's quality of life, but also the numerous medical and legal ramifications for the anesthesia providers. Although POVL is considered an unusual complication, the need to understand the frequency of POVL and related risks and causes are important issues. In 1999, the American Society of Anesthesiologists’ (ASA) Committee on Professional Liability created the ASA Postoperative Visual Loss Registry to document cases of POVL and to improve and understand the problem and possibly its causes (Stoelting & Miller, 2007).
Reports of loss of vision have occurred after various nonocular related surgical procedures. Some examples of these are cardiopulmonary bypass, spinal surgery, hip arthroplasty, abdominal procedures, craniotomies and procedures involving the neck or the head (Morgan, Mikhail & Murray, 2006). The three established causes of postoperative visual loss are ischemic optic neuropathy (ION) either anterior (AION) or posterior (PION), central...
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After the operation concludes, Dr. Todd and her team reverse the local anesthesia, inject novocaine into the eye, and educate the patient on what they need to do before their post-op checkup. Since cataract surgery is an outpatient procedure requiring no hospital stay, patients go home and return the following day for their
It is important that the patient keeps in contact with the doctor after the surgery because if the individual has any problems after the surgery, the doctor can fix it. The patient can notice that something is wrong when some of the symptoms happen. Those symptoms are numbness or weakness on the face, arm, leg, or on one side of the body, unexpected confusion which can impair the person from understanding normal conversation and be able to speak. Also, the individual may have a vision loss on either one or both eyes, individual can have loss of coordination, etc. (Beaumont, 2015). Individuals have to be careful when having those symptoms because they can be
3. Childs NL, Mercer WN. Brief report: late improvement in consciousness after post-traumatic vegetative state. N Engl J Med 1996;334:24-25. (report of a 16 year old patient with PVS who recovered significantly after 17 months).
With no treatment needed, glaucoma is a leading cause of blindness in the United States, while simultaneously being the number one leading cause in Africa (Glaucoma Research Foundation). According to the American Optometric Association, “Glaucoma is a group of eye diseases causing optic nerve damage. The optic nerve carries images from the retina, which is the specialized light sensing tissue, to the brain so we can see.” They go on to say that when dealing with glaucoma, one’s eye pressure plays a vital role in damaging the delicate nerve fibers of the optic nerve. “When a significant number of nerve fibers are damaged, blind spots develop in the field of vision. Once nerve damage and visual loss occur, it is permanent.” The National Institute of Health states that due to shallower anterior chamber depths, this defect hurts the lives of people mostly from East Asian descent. The Foundation continues to say that blacks are among the people who are three times more likely to have glaucoma while woman in general are two times more likely to developing angle closure glaucoma.
Although the comorbidities and type of surgery dictate certain decisions in managing patient care, anesthesiologists maintain various modalities for the perioperative period. These consist of anything from local to regional anesthesia, including neuraxial techniques and peripheral nerve blocks, as well as monitored anesthesia care with sedation to general anesthesia. Overlapping of different anesthetic types and combinations of regional analgesics to supplement general anesthesia occur frequently.
Life revolves around being able to see things. Although individuals who are blind can lead a full and happy life, someone with excellent vision who suddenly loses theirs or notices a decrease in their visual acuity over time may find it difficult to adapt. Thankfully, with the help of an optometrist, individuals can actively work to preserve their vision for as long as possible. Phoenix Eye Care must be a priority for all, as advanced technology allows threats to the eyes to be detected as the earliest stage. The right treatment can help to slow or stop the progression before major issues develop. For this reason, every individual needs to undergo routine eye exams.
-“Find evidence of damage in at least two separate areas of the central nervous system (CNS), which includes the brain, spinal cord and optic nerves AND
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The surgery worked well as a cure for patients who suffered from severe epilepsy and did not respond to anti-epileptic drugs. It was soon realized that patients who had a commissurotomy had some interesting difficulties. Patients were not able to communicate information from one hemisphere to the other, almost as thought now had two distinct separate brains. Several experiments were done to test perception in the "split-brain" patients.
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However, these pains are easily taken care of with just rest and taking things slowly and the symptoms will subside (“Bidmc). The second phase of physical symptoms is dizziness. Classifying what a person means by dizziness can severely affect the treatment of the symptom. A mild case of poor equilibrium like lack of balance is one thing, that can simply be cured with rest and patience. However, if the symptom is more serious, like not being able to walk or vomiting from the dizziness, this could be caused by a more serious injury to the brain and medical attention should requested. The best way for a patient to avoid dizziness is to not overdue activity, consistent rest, and slowly move into more physical activities. Nausea and motion sickness are fairly common such as migraines and queasiness. These are also related to equilibrium issues. The severity of the nausea and headaches differ between the severity of the head injury. Just upset stomachs and getting nauseous from car rides are caused from fairly mild brain trauma, but more severe sickness such as vomiting, not being able to eat and hold down
Cataract surgery may be the most commonly performed procedure around the world, but not every case is routine; many patients present with retinal or corneal conditions that require surgeons to take extra precautions before, during and after surgery.
The effects include paralysis of a limb or one side of the body and disturbances of speech and vision. The nature and extent of damage depends on the size and location of the affected blood vessels. The main causes are cerebral infarction (approx. 85%) and spontaneous intracranial haemorrhage (15%) (Waugh & Grant, 2010).
There are 3 common types of eye injury: a corneal laceration (a cut or puncture wound), a globe rupture (bursting of the eye ball, and an optic nerve avulsion (complete tearing of the optic nerve), ea...