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SurgSpace / Specialties / Ophthalmic Surgery

Ophthalmic Surgery

Surgery of the eye: cataract, retina, glaucoma and the open globe. The two operations every student should know are here; Mediverse also has a whole platform for the eye, so this specialty hands you across rather than duplicating it.

2 operations in depth5 interactive casesContinue in OphthoSpace

Backdrop: A surgeon performing cataract surgery · Wikimedia Commons · Public domain

After, and when it goes wrong

Post-op & Emergencies

The expected course, the ward reads, and the calls that cannot wait.

The expected course and the ward reads, then the complications and the calls that cannot wait.

On the ward

Three boards, three reads

  • POD 2 · phacoemulsification

    Increasing pain since last night

    Vision worse than day 1

    Red eye, hazy view

    Drops used as prescribed

    Why is this phone call an emergency?

    The read

    Because worsening pain plus falling vision after intraocular surgery is endophthalmitis until proven otherwise: an infection inside the globe measured in hours of retina. The pathway is same-day ophthalmic review for examination, an intravitreal tap for culture and antibiotics injected where the infection lives. The routine operation's rarest complication is the reason every post-op leaflet says 'pain plus worsening vision: call now'.

  • POD 1 · vitrectomy with gas for retinal detachment

    Gas bubble in situ

    Posturing face-down as instructed

    Asks about flying home next week

    Vision: hand movements (expected with gas)

    What are the bubble's rules?

    The read

    The bubble is a tool with physics attached: posture positions it against the tear (hence the face-down instructions), the poor vision through gas is expected and temporary, and altitude is forbidden: a gas bubble expands as pressure falls, and a flight can turn the eye into an angle-closure emergency at 30,000 feet. Nitrous oxide anaesthesia is banned for the same reason, which is why the wristband matters.

Emergencies

The calls that cannot wait

  • Acute angle closure

    Recognise: Severe unilateral eye pain with vomiting, halos, a mid-dilated fixed pupil and a hard globe: pressure climbing against the optic nerve.

    First move: Ophthalmology by phone while treatment starts: pressure-lowering drops and systemic acetazolamide now, definitive laser iridotomy (both eyes) once the pressure yields.

    Run it as a case

  • The open globe

    Recognise: Laceration, peaked pupil, shallow chamber, or simply the hammering-metal history with any eye symptom: breached until proven otherwise.

    First move: Shield without pressure, nil by mouth, antiemetics, tetanus, CT orbits, and ophthalmology: no drops, no pads, no prying.

    Run it as a case

  • Orbital cellulitis

    Recognise: The red swollen lid plus any deep sign: pain on movement, restriction, proptosis, visual or pupil change, or a lid too swollen to assess.

    First move: Admit, IV antibiotics, CT, and joint ophthalmology-ENT review: the subperiosteal abscess is drainable, and the optic nerve's hours matter.

    Run it as a case

  • The macula-on detachment

    Recognise: Flashes, floaters and a progressing curtain with central vision still intact: the fovea is still attached and still savable.

    First move: Same-day retinal referral with the macula's status in the first sentence, posturing advice while theatre is arranged, and urgency measured in hours, not clinics.

    Run it as a case

Hub shaped by the Surgical Specialties Lead with the Ophthalmic surgery reviewer (open seat). Images and videos carry their source; educational use for supervised learning, not clinical guidance.