Anaesthetic Considerations for Bilateral Congenital Anophthalmia

Congenital anomalies planned for ocular surgeries range from the rare to atypical to common. Many of this rare ophthalmopathy are associated with clinical syndromes and have important anesthetic implications. Not only is it important to know the syndrome we are dealing with, but it’s also the more important to understand the systems that are involved, the extent of involvement, potential anesthetic complications, right from the cerebrovascular, cardiovascular, endocrine, metabolic, neuromuscular, genitourinary systems to airway. Understanding these aspects becomes more important in rare clinical scenarios as it helps to plan the case, anticipate and treat the complications. Congenital anophthalmia is one of the rare conditions with an incidence of <3/1000 with microphthalmia reported in up to 11% of blind children, hence we report management of a rare case of bilateral congenital anophthalmia planned for excision of right ocular swelling with objective to describe the anaesthesia challenges faced during the intraoperative and postoperative period. Detailed preoperative workup of the patient helps to anticipate, understand and manage the intra-operative complications that may arise during the course of surgery.