Damage Control Ophthalmology: Anesthesia Considerations

  • Colonel Mark H. ChandlerEmail author


Safe and effective anesthetic management of ocular trauma remains an important skillset for the military anesthesiologist. Integral to this is a familiarity with ocular anatomy and physiology, particularly the factors affecting intraocular pressure. While regional and topical anesthesia is useful for minor eye procedures, general endotracheal anesthesia (GETA), particularly in the likely setting of accompanying facial trauma, remains the standard of care for most serious ocular trauma cases. Performing a general anesthetic for eye trauma, especially an open globe, requires a careful balance between creating ideal operating conditions, safeguarding the airway, and preventing the further deterioration of already compromised vision.


Anesthesia Trauma Eye block Open globe Oculocardiac reflex Intraocular pressure Succinylcholine Retrobulbar block Peribulbar block Sub-Tenon block 



Airway breathing circulation


American Society of Anesthesiologists


Birmingham Eye Trauma Terminology System


cubic centimeter


Cranial nerve


Endotracheal tube


Face-down position


General endotracheal anesthesia


Improvised explosive device


Intraocular pressure


Joint Theater Trauma Registry


Local anesthesia


Massive hemorrhage, airway, respiration, circulation, head/hypothermia




Nondepolarizing muscle relaxant


nil per os (nothing by mouth)


Oculocardiac reflex


Peribulbar block


Retrobulbar block


United States of America


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.COL (RET), MC, Colorado Army National Guard, Department of AnesthesiologyDenver Health Medical CenterDenverUSA

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