Post anesthetic blindness

Mrs. A underwent surgery under GA, she was under sedatives and painkillers for next 2 days and it was only on the 3rd post operative day that she realised that her vision was very blurred and she had more pain around her eyes and in her head that in the operated area.

Her Ophthalmic examination revealed a picture of an acute angle closure glaucoma. Obviously being under GA she hadn't experienced the pain of the acute angle closure which is comparable to the pain of a MI.

The hypothesis was that Mrs. A being a hypermetrope with shallow anterior chamber and occludable angles had gone into acute angle closure due to the effect of some anti cholinergic agent administered as part of the GA medications.

Being positioned in prone position for prolonged period can impinge the iris lens diaphragm against the angle triggering an acute angle closure 

Just asking the patients if their glasses are plus or minus power and if plus getting a gonioscopy done, and if angles are occludable getting a prophylactic YAG laser iridotomy done before GA could save people from needless blindness.

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