Paediatric Ophthalmic Anaesthesia, Strabismus, Retinoblastoma, and the Oculocardiac Reflex — WACS Viva & Clinical Scenarios (ENT & Ophthalmology)

Exam-style paediatric ophthalmic anaesthesia, strabismus, retinoblastoma, and the oculocardiac reflex viva scenarios with examiner probes and model answers for…

Scenarios covered

• SCENARIO 1: A 4-year-old boy (ASA I) undergoing medial rectus traction during strabismus repair suddenly develops severe sinus bradycardia (HR dropping from 110 bpm to 32 bpm) followed by junctional escape rhythm. Detail your immediate step-by-step intraoperative management.
• SCENARIO 2: A 2-year-old child (ASA II) presents for examination under anaesthesia (EUA) and measurement of intraocular pressure (IOP) for suspected congenital glaucoma. Describe how your choice of anaesthetic agents and airway management can distort IOP measurements.
• SCENARIO 3: A 3-year-old female (ASA I) presents for enucleation of an eye with advanced unilateral retinoblastoma. Outline your complete anaesthetic management plan, focusing on deep extubation, PONV prevention, and systemic monitoring.
• SCENARIO 4: A 5-year-old boy (ASA I E) who ate a plate of rice 2 hours ago sustains a penetrating corneal laceration from a broken glass toy. Formulate an anaesthetic plan that safely mitigates aspiration risk while preventing extrusion of intraocular contents.