• Laura McRae and Andrew Presland.
• Moorfields Eye Hospital NHS Foundation Trust.
• Br. Med. Bull. 2020 Oct 14; 135 (1): 62-72.

IntroOphthalmic surgery ranks among the commonest procedures performed worldwide. This review considers the range of anaesthetic techniques available to the modern ophthalmic anaesthetist, and practical considerations to evaluate in different circumstances. There is a brief summary of the main issues pertaining to the common ophthalmic subspecialties and operations.Sources Of DataPubmed.Areas Of AgreementWe present a view of contemporary ophthalmic anaesthetic practice as we see it, both from current UK clinical experience, and the available published evidence.Areas Of ControversyThere is an ongoing debate about the safety of sharp needle blocks (SNBs) compared to subtenons and topical techniques, but SNBs still have a role to play, both in specific cases, and in circumstances where resources are limited.Growing PointsIt remains a challenge to provide safe, cost effective anaesthesia to a growing patient base with ever increasing demands and medical comorbidities. There is a continuing trend towards replacing general with local anaesthesia where possible.ResearchResearch in ophthalmic anaesthesia, as in so many areas, has been plagued by heterogeneity and small studies. A coordinated, large scale, multicentred approach to research questions in future would help to guide best practice with more certainty.© The Author(s) 2020. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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