By Erna E. Kritzinger

ISBN-10: 0723409153

ISBN-13: 9780723409151

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Extra resources for A Colour Atlas of Optic Disc Abnormalities

Example text

May use iris hooks. i. Create 4 paracentesis sites at 2, 4, 8, and 10 o’clock positions. ii. Place paracentesis incisions posteriorly in the limbus and parallel to iris to avoid tenting of the iris when hooks in place. iii. Grasp iris hook with fine forceps or needle holder and insert into anterior chamber with hook parallel to the iris plane (Fig. 6). Drive the point of the blade through the stroma until it is 2 mm central to the external incision. Some blades have line marks on the surface to indicate the 2 mm landmark.

Cauterize as necessary to stop bleeding. Use 15 mm, 25G blunt tipped cannula; make sure it is through all layers of Tenon capsule. Position cannula straight so that it is essentially parallel to the optic nerve (ensures that the anesthetic will encircle the globe). Slowly inject 2–3 ml of anesthetic subtenons in the periequatorial region. Note: If chemosis is noted, reposition the cannula under all layers of Tenon capsule. 7 ■ Remove cannula. May close conjunctival opening with cautery if needed.

Advance needle, piercing intermuscular septum and enter muscle cone. Gently move needle from side to side, looking for any movement of eye as a clue that the globe has been penetrated. Aspirate syringe to ensure a blood vessel has not been entered. 8 ■ ■ Slowly inject 3–4 ml of anesthetic solution. Remove needle. ■ Apply pressure to prevent hemorrhage and facilitate diffusion of anesthetic. ) ■ Complications. ❏ Retrobulbar hemorrhage. ❏ Central retinal artery occlusion. ❏ Intravascular anesthetic injection.

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A Colour Atlas of Optic Disc Abnormalities by Erna E. Kritzinger


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