plnnr’s hair-raising post about eye surgery raised a question in my tiny mind: why can’t you have general anesthesia for eye surgery? Surely they have clips or clamps or something that can hold your eye open during the procedure?
I had eye surgery back in 1997…a cornea transplant. I had general anesthesia at the time.
They do have lid retractors to keep the open.
Slideshow photos here (not for squeamish)
The risks of general anesthesia are too great to use on a patient that is having a short procedure on that part of the body. Like having a cavity filled.
There’s probably something about the gasses and drugs that increases intraocular pressures or something, but I’m no anesthesiologist.
To clarify my above post…my surgeon gave me anesthesia because she didn’t want me to move AT ALL (and I think for anxiety issues if I remember correctly) . Apparently this varies from surgeon to surgeon…
I was given a general twice for two different eye surgeries (cataracts). I have claustrophobia and they were very worried that I might move during the procedure. I could not absolutely guarantee that I could keep still.
I had recently had an MRI in which I got as far as my shoulders before panicking. The technician didn’t get me out fast enough so I hit him. I was so ashamed, but he was pleasant about it. I’d had no idea that I was claustrophobic until that point. That experience made it impossible for me to even be in a bedroom with the door closed, so having drapes over my face simply wasn’t going to happen.
In both cases it was a very light anaesthetic and I had no ill effects.
I would not only move during eye surgery, I would change my name and leave no forwarding address! So it’s good to know that general anesthesia is indeed possible.
Eve, I was under general anasthesia for the main part of the surgery (it took about 2 hours). It was only after that main operation that the dr. said, “You’ve got a little piece of scar tissue in the corner of your eye from previous surgeries and we can remove it in the office.” I had to come back about a week later to have the old needle in the eyeball.
You’re correct, they do have a little spring-loaded gizmo that they use to keep your eye open during surgery and someone provided a link to a pic earlier. They have to continually put artificial tears in your eyes so they won’t get too dry, as well.
I had lazy eye as a child and had 6 different surgeries to try and correct it. They finally got it right when I was 35, so I’m an old hand at having dr’s mess around with my eyeballs.
Yurrrgh! It’s how I felt/feel too. Though since then I have become able to cope with eye exams, even the yukky ones so long as they don’t involve being in anything smaller than a largish room. A few weeks ago I needed a field of vision test (spotting light dots in a large black box) and the test was in a small room no bigger than a cupboard. I was sweating by the end, just desperate to get out of the room.
To get back to the eye surgery, the other thing they did which we did discuss before hand was to put a metal sheild and a lot of bandages on the eye before I woke up (actually I remember being bandaged). That was to stop me randomly reaching up to rub my eye as I was coming round. If you have the normal procedure you just get a piece of gauze, the metal mesh thingy and a little bit of tape.
As a total aside, I had the surgery about seven years ago now, and I still remember the moment they took the bandage off after the first surgery. It was the afternoon of the operation, and as they lifted the bandage away, I nearly fell off the chair as the light hit the back of my eye. I think they must be used to that as the nurse had her hands on my back! Even without glasses, and with the massive distortion of the cut (for a few days I could see where the cut was as it showed itself as a notch in straight lines such as doorways), I could SEE! There was a hole wall full of little drawers of equipment in the doctors office that I had thought was a plain wall. And that busy road system outside the window that I had thought odd with the random spurts of traffic on it? It was a driving school. And in the six months that I hadn’t been able to see my kids hair had changed colour (he was two, so actually he had grown hair!) and my husband had gone grey. He kept saying “Stop staring at me” but I couldn’t. And the backs of my hands were all wrinkly. And I couldn’t eat smoothly for days because I kept getting caught up in the stripes on an apple skin, or the fibres in fish flesh.
I never, ever want to forget those sensations, and to take for granted my sight. I was in my early 30’s when I had my operations, and the basic conditions that caused my problems have not gone, so I have been warned that things might go awry again in the future. If you need an eye check up GET IT DONE. There is so much that can be done to prevent a bad situation getting worse (I have glaucoma now just for laughs, but it is well controlled) but once the damage is done, that’s it, no going back.
Good luck!
I will, I will, I will. I even got Oxymoron to recommend an eye doctor in NYC.
At least they use the “puff of air” glaucoma test now—anyone old enough to remember the old-fashioned glaucoma test, where they strapped your head in and a metal rod came out and touched your eyeball to test the pressure? The doctor never told me the damn thing was going to touch my eyeball, so I thought he forgot to turn the machine off and it was going to go all the way through my head! I yanked myself out of the restraints and ran screaming from the office.
When I had the various surgeries as a child (got my first pair of glasses at age 2, had my first surgery at 4, then at 6, then at 7, then at 10, then at 11, then at 35) they would wrap my hands up in gauze so that I couldn’t mess with the bandages. They looked liked little pairs of boxing gloves. I know this because my mother kept them and still has them in a drawer at her house.
“Aw, here’s Lee’s first pair of booties. And his little red vest I made him for Christmas. And look…here’s the bandages they put on his hands when they took his eyeballs out!”
I had an optometrist who did the touch-your-eye glaucoma test. It wasn’t traumatic at all, I think he gave me numbing drops and then did it with this little pen-like object. Weird, but no problem. I do have some family history of glaucoma, so I think he was just being extra-careful even though I’m pretty young.
After I had a cornea transplant I had several follow up sessions with the surgeon.
At those sessions, she had to go in with a forceps and scapel to take out the stitches.
No I did not have any medication.
It didn’t “hurt” that much, but feeling the surface of your cornea being stretched out with the forceps…and knowing that a scapel is slicing stitches on your damn eyeball freaked me out a bit.
faints dead away
I had semi-eye surgery when I was 6 months, and then again when I was 7 - it was some sort of correction to the muscles around my eye. They most definitely knocked me out (and I think they used too much anesthesia, as I proceeded to sleep for the next 30 some hours, straight!) Nothing like having intensely sore eye muscles, I’ll tell you…
I also, every time I go to the opthamologist, get those dilating drops in my eyes and often numbing ones as well, so he can poke and prod as needed. I personally find that combination just as intolerable.
I had a co-worker who had the older type of eye correction sugery back when they used scalpels instead of lasers. He was given local anesthesia and told to hold his eyes steady during the procedure. Just as he was about the begin, the doctor said, “I want you to focus.” As my friend explained, “This guy was standing over me about to stick a razor in my eye. He had my full attention and I was never more focused on anything in my life.”
I was 10 when they corrected my lazy eye, and I was under general. My mom tried to convince me to go for local, because it was cheaper. :eek: I was 10, for Og’s sake!
The last two times I was in the same room as an opthalmologist, they (two different docs and different cities) used a tonometer that was part of that “Which is better - this one or this one?” rig after putting in some anaesthetic drops. I asked about it, and was told that the contact method was more accurate than the puff device.
After some 15 years of sticking my fingers into my eyes every day, and realizing that about a week later, I was going to have the tip of my eye sliced open and lasered, I wasn’t too worked up over it.
There’s also a portable version, known as a tonopen. Anyone that saw “ER” about a week or two ago where a kid’s eyeball popped out saw one in use. (He sneezed with his eye open)
As for not being unconscious - nobody’s mentioned LASIK yet. For that, you need to be able to focus on a target. Not too easily done if onconscious. 
Oh, and even though the last time I was under it made me sick as a dog, I’m not getting eye surgery awake. No way in hell am I doing that.
Don’t your eyeballs roll back in their sockets when you’re unconscious?
I’ve worked in ophthalmology for a few years now (IANAD/N), and can confidently say I’ve never seen an eye pop out with the use of a tonopen.
They give you some kind of sedation for the LASIK, so you’re relaxed at least. Plus the computer tracks the eye and readjusts the laser position, or shuts it down entirely, should you happen to move. Plus it’s over so fast, the risk associated with general anesthesia isn’t considered worth it.
General anesthesia may well be used for more complicated surgeries, but there are all different levels of surgery involved with an eye. It’d be like putting someone under for stitches, for instance. I understand (all too well) how eyes tend to get people more squeamish about what’s being done to them, though.