Journal français d'ophtalmologie
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A consecutive series of 100 patients with retinal detachment underwent surgery with local regional anesthesia (sedation plus peribulbar anesthesia). All patients were informed about the anesthesia alternatives (general and local regional) and the differences were explained. Ninety-seven patients chose local regional anesthesia. ⋯ Local regional anesthesia requires close collaboration of surgeon, anesthesiologist and patient. The main advantages of this technique are: its simplicity, the absence of oculocardiac reflex, diminution of pain, and the possibility of placing the patient in the desired position very shortly after surgery. The limitations of local regional anesthesia are: procedures that take longer time, and lack of patient comfort.
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Review Case Reports
[Definitive transient monocular blindness caused by ocular compression during general anesthesia].
We present a case of irreversible monocular blindness caused by obstruction of the central retinal artery detected in a young patient without any previous history, when waking up from a surgical procedure performed under general anesthesia. Clinical and complementary investigations were not conclusive. ⋯ The fact that the patient was simultaneously submitted to a controlled low blood pressure may have worsened the effects of the compression. Reviewing the medical literature on the subject reveals that, although rare, such accidents do occur; they must be prevented by a constant surveillance when performing surgical procedures.
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Review Case Reports
[Ophthalmological anomalies of the GAPO syndrome (growth retardation, alopecia, pseudo-anodontia, optic atrophy). Apropos of a case].
G. A. P. ⋯ P. O. syndrome with ocular abnormalities and bilateral optic atrophy. Physiopathogenic hypotheses are discussed, especially concerning optic disc alterations which are probably due to intraocular hypertension.
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Transitory eye pain occurred during sleep in a 62 year-old patient, who complained of being often awoken during the second half of the night. Diurnal ophthalmologic examinations did not reveal any abnormality. Three consecutive nocturnal polysomnographic recordings were performed to determine whether these pain crises were related to any sleep stage. ⋯ On the three occasions, the crisis occurred during of immediately after a REM sleep phase. The brievity of the pain episode (4 to 5 min) did not allow a quick eye pressure measurement to demonstrate a possible increase in ocular tension. However, the role of the REM sleep myosis and vegetative manifestations are discussed regarding the determination of eye pain.