92018 Ophthalmological examination and evaluation, under general anesthesia, with or without manipulation of globe for passive range of motion or other manipulation to facilitate diagnostic examination; complete

Name of the Procedure:

Ophthalmological Examination and Evaluation under General Anesthesia (with or without manipulation of the globe for passive range of motion or other manipulation to facilitate diagnostic examination); Complete

Summary

An ophthalmological examination and evaluation under general anesthesia is a thorough eye examination conducted while the patient is asleep. This allows the healthcare providers to perform a complete and detailed assessment of the eyes, which may include manipulating the eye (globe) to explore its full range of motion and other diagnostic manipulations.

Purpose

This procedure is performed to diagnose or evaluate complex eye conditions when a patient cannot remain still or maintain eye alignment during a standard examination.

Goals:

• Accurate assessment of eye structure and function
• Identification of any existing abnormalities or conditions

Indications

• Children or adults unable to cooperate with a traditional eye exam due to age, fear, or disabilities
• Suspicious or complex eye conditions requiring thorough internal examination
• Need for manipulation of the eye to determine the extent of a condition or the range of motion

Preparation

• Patients might need to fast (avoid food and drink) for a specified period before the procedure.
• Certain medications may need to be adjusted or paused as instructed by the physician.
• Pre-procedure assessments could include blood tests, electrocardiograms (EKG), and possibly imaging studies.

Procedure Description

1. Anesthesia: General anesthesia is administered, ensuring the patient is completely unconscious and pain-free.
2. Examination: The eye specialist will use various instruments to open the eyelids and examine the external and internal structures of the eye.
3. Manipulation: If necessary, the globe (eye) will be gently manipulated to assess the passive range of motion or conduct other diagnostic procedures.
4. Observation: Detailed observations of the cornea, lens, retina, and other structures are recorded.
5. Concluding Evaluation: Diagnostic findings are documented to inform further treatment.

Equipment:

• Ophthalmic examination tools (e.g., slit lamp, ophthalmoscope)
• Anesthetic machines and monitoring devices

Anesthesia:

• General anesthesia administered by an anesthesiologist or nurse anesthetist

Duration

The entire procedure typically lasts between 1 to 2 hours, depending on the complexity of the examination.

Setting

Performed in a hospital operating room or specialized surgical center equipped for comprehensive eye exams under anesthesia.

Personnel

• Ophthalmologist (Eye Surgeon)
• Anesthesiologist or Nurse Anesthetist
• Surgical Nurses
• Anesthesia Technicians

Risks and Complications

Common Risks:

• Mild discomfort or irritation post-procedure
• Temporary blurred vision

Rare Risks:

• Complications from general anesthesia (e.g., allergic reactions, respiratory issues)
• Eye infections or bleeding
• Damage to ocular structures

Benefits

• Comprehensive and unobstructed evaluation of eye condition.
• Diagnosis and treatment planning for intricate eye problems.
• Improved accuracy in assessing conditions that couldn't be evaluated with the patient awake.

Recovery

• Post-procedure observation until the effects of anesthesia wear off.
• Instructions for eye care, including the use of antibiotic or anti-inflammatory drops.
• Restriction from activities such as swimming or heavy lifting for a few days.
• Follow-up appointments to monitor recovery and treatment progress.

Expected Recovery Time:

• Most patients resume normal activities within 24 to 48 hours.

Alternatives

• Office-based eye examination (limited to cooperative patients)
• Less invasive imaging studies (e.g., Optical Coherence Tomography)

Pros and Cons:

• Pros: Non-invasive alternatives involve less discomfort and risk.
• Cons: May not provide as detailed or comprehensive results as the procedure under anesthesia.

Patient Experience

• During: The patient is asleep and unaware during the procedure.
• After: Mild discomfort, slight irritation, or blurred vision may be experienced. Pain management, if needed, can be addressed with mild analgesics. Clear communication with the medical team will be provided to ensure comfort and proper aftercare.