General anesthesia for ophthalmic surgery.

Skillful anesthetic management is integral to optimal outcomes after ophthalmic surgery. Although the majority of ophthalmic operations in the United States are performed with local anesthetic techniques, nonetheless general anesthesia may be either necessary or advisable in several challenging circumstances. Ophthalmic patients are often at the extremes of age, and not uncommonly have extensive associated systemic or metabolic diseases. Because the complications of ophthalmic anesthesia can be vision threatening or life threatening, it is imperative that the ophthalmologist and the anesthesiologist understand the complex and dynamic interaction among patient diseases, anesthetic agents, ophthalmic drugs, and surgical manipulation. Effective communication and planning among all involved are essential to safe and efficient perioperative care.