Yeungnam University Journal of Medicine  2017;34(2):290-292

doi:10.12701/yujm.2017.34.2.290

Suddenly fixed upward ocular deviation under general anesthesia.

Won Jae KIM 1 ; Sang Jin PARK ; Myung Mi KIM

Affiliations

+expand

Keywords

Strabismus; General anesthesia; Muscle relaxant

Country

Republic of Korea

Language

English

Abstract

Various changes in ocular position are possible during general anesthesia as opposed to the awakening state. However, unexpected ocular deviation under general anesthesia is a disconcerting event as it can lead to difficult complications intraoperatively. To date, sudden fixed upward ocular deviation has been rarely reported previously. This phenomenon was observed in an 8-year-old boy during strabismus surgery. Suddenly fixed upward ocular deviation occurred when the speculum was inserted into the right eye. When the eyeball was pulled down, using forceps, there was some resistance, such as contracture of superior rectus. The eyeball sprang back into the upward position when the forceps was released. These changes could hamper the good exposition of the surgical field, leading to significant intraoperative difficulties and complications. Surgeons should be aware of this possibility, despite general anesthesia; if it occurs, proceed with the surgery as planned preoperatively, and both ophthalmic and anesthetic interventions should be used to solve this problem.