Management
Î The operating ophthalmologist should provide those aspects of
postoperative eye care that are within the unique competence of the
ophthalmologist. (III, G, S)
Î The ophthalmologist who performs surgery has an obligation to
inform patients about appropriate signs and symptoms of possible
complications, eye protection, activities, medications, required visits,
and details for access to emergency care. (III, G, S)
Î The ophthalmologist should also inform patients of their responsibility
to follow advice and instructions provided during the postoperative
phase and to notify the ophthalmologist promptly if problems occur.
(III, G, S)
Î Patients should always have access to an ophthalmologist for
appropriate care if serious problems arise. (III, G, S)
Î Patients should be instructed to contact the ophthalmologist promptly
if they experience symptoms such as a significant reduction in vision,
increasing pain, progressive redness, or periocular swelling, because
these symptoms may indicate the onset of endophthalmitis. (III, G, S)
Î In the absence of complications, the frequency and timing of
subsequent postoperative visits depend largely on the size or
configuration of the incision, the need to cut or remove sutures, and
when refraction, visual function, and the medical condition of the
eye are stabilized. More-frequent postoperative visits are generally
indicated if unusual findings, symptoms, or complications occur. The
patient should have ready access to the ophthalmologist's office to ask
questions or seek care. (III, G, S)
Î A final refractive visit should be made to provide an accurate
prescription for eyeglasses to allow for the patient's optimal visual
function. (III, G, S)
Components of Each Postoperative Examination Should
Include the Following:
• Interval history, including use of postoperative medications, new symptoms, and
self-assessment of vision
• Measurement of visual function (e.g., visual acuity, including pinhole testing or
refraction when appropriate)
• Measurement of IOP
• Slit-lamp biomicroscopy
• Counseling/education for the patient or patient's caretaker
• Management plan
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