(a) The loss of vision or any interference with the use of the eyes, even
temporarily, has a severe emotional effect on any person. It means loss of mobility and
ability to take care of or protect oneself. This tends frequently to make the patient
nervous and sometimes depressed. The patient is often awake during the entire
operation. All operating staff members should allay the fears of each patient. The
emotional state of the patient is an important factor in a successful recovery.
(b) A quiet environment and a calm, kindly, understanding voice create
confidence in the patient. The patent's comfort is further enhanced by pleasant
surroundings and freedom from noise and confusion. When a patient is sedated, he is
often unable to speak coherently, but is usually conscious of noises, which become
exaggerated in his mind.
Drugs which may be given.
(a) To allay anxiety and reduce general muscle tone, the patient is
usually given a barbiturate-narcotic drug on call to surgery, as well as any ophthalmic
drugs that may be prescribed. This is often followed by topical anesthetic drops upon
arrival at surgery (see figure 1-2).
Observe the position of the dropper and the capillary attraction.
(b) Mydriatic drops are used to dilate the pupil with the patient retaining
the ability to focus his eye. This is usually 10 percent phenylephrine (Neo-Synephrine ).
(c) Cycloplegic drugs dilate the pupil and prevent focusing of the eye.
Commonly used cycloplegics are 1 percent tropicamide (Mydriacyl), 1 percent atropine,
and 1 percent cyclopentolate (Cyclogyl ). Atropine has a long-lasting effect.