In our first paper the preoperative management for an uncomplicated retinal detachment was discussed.1 In many instances, however, patients with retinal detachment present additional problems which may modify the preoperative care of the patient. The most important of these problems are interference with satisfactory ophthalmoscopy, glaucoma, uveitis, choroidal detachment, external infections, medical disorders, and emotional instability. In this paper the management of patients showing these difficulties will be discussed.
Interference With Ophthalmoscopy
Corneal haziness may develop during the course of ophthalmoscopy. This is due to epithelial edema following drying of the corneal epithelium. The use of local anesthetic agents, such as 0.5% tetracaine hydrochloride, aggravates this type of corneal edema; therefore, local anesthetics should be used only when absolutely necessary, and, if possible, near the end of the examination. Proparacaine hydrochloride 0.5% has been found to cause the least disturbance of the corneal epithelium. In addition, to minimize corneal
BROCKHURST J, SCHEPENS CL, OKAMURA ID, REGAN CDJ, MCMEEL JW. Scleral Buckling ProceduresVIII. Preoperative Complications. Arch Ophthalmol. 1965;74(6):792-798. doi:10.1001/archopht.1965.00970040794010