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Quantification of relative afferent pupillary defects induced by posterior sub-Tenon's, peribulbar, and retrobulbar anaesthetics

Lookup NU author(s): Neeta Ray-Chaudhuri, Dr David WalshawORCiD


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Aims-The effect of local anaesthetics on optic nerve function can be investigated by quantifying the relative afferent pupillary defect (RAPD). Methods-The study compared the depth of induced RAPD following posterior sub-Tenon's, retrobulbar, and peribulbar local anaesthetics using crossed polarising filters before cataract surgery (time 1 = 5 minutes), immediately after surgery (time 2 = 42 minutes (av)), and once again on the ward (time 3 = 107 minutes (av)). Results-All patients developed a RAPD. There was no significant difference in the depth of RAPD between the groups at any one time period. The peribulbar group had a significantly steeper decay in RAPD from time 1 to time 2 (p = 0.014). This effect was reduced when the shorter operation time for this group was entered as a cofactor (p = 0.063). By time 3 the RAPDs for all groups had decayed similarly so that no differences could be detected. Conclusion-All three anaesthetic methods caused a similar level of disruption to optic nerve conduction immediately following administration and at the time of day case discharge.

Publication metadata

Author(s): Walshaw D; Ray-Chaudhuri N; Ramsay AS; Dayan M

Publication type: Article

Publication status: Published

Journal: British Journal of Ophthalmology

Year: 2001

Volume: 85

Issue: 12

Pages: 1445-1446

ISSN (print): 0007-1161

ISSN (electronic): 1468-2079

Publisher: BMJ Publishing Group Ltd


DOI: 10.1136/bjo.85.12.1445


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