Adult Ophthalmic Anaesthesia, Open Globe Trauma, Glaucoma, and Ophthalmic Regional Blocks — WACS Viva & Clinical Scenarios (ENT & Ophthalmology)

Exam-style adult ophthalmic anaesthesia, open globe trauma, glaucoma, and ophthalmic regional blocks viva scenarios with examiner probes and model answers for…

Scenarios covered

• SCENARIO 1: A 72-year-old diabetic, hypertensive male (ASA III) is scheduled for small incision cataract surgery under peribulbar block. Three minutes after block administration, he becomes apnoeic, uncommunicative, develops bilateral fixed dilated pupils, and loses consciousness with BP 60/35 mmHg. Detail your immediate diagnosis and resuscitation plan.
• SCENARIO 2: A 64-year-old female (ASA III) with severe end-stage open-angle glaucoma on long-term topical timolol, topical dorzolamide, and oral acetazolamide is scheduled for emergency trabeculectomy. Outline the systemic pharmacological and metabolic derangements you must evaluate and optimize preoperatively.
• SCENARIO 3: A 28-year-old male (ASA I E) presents with a ruptured globe after a road traffic collision 1 hour ago; he has a full stomach and is in severe distress. Detail your anaesthetic induction, maintenance, and emergence plan ensuring zero extrusion of intraocular contents.
• SCENARIO 4: A 58-year-old female undergoes pars plana vitrectomy for complex retinal detachment during which the vitreoretinal surgeon injects sulfur hexafluoride (SF6) gas. Discuss the precise anaesthetic considerations regarding volatile agents, nitrous oxide, and postoperative anaesthetic precautions for future general surgeries.