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Anesthesia considerations in pediatric glaucoma management

Chang, Ta C.; Cavuoto, Kara M.

Current Opinion in Ophthalmology: March 2014 - Volume 25 - Issue 2 - p 118–121
doi: 10.1097/ICU.0000000000000032
GLAUCOMA: Edited by Donald L. Budenz

Purpose of review This article reviews the potentially adverse neurodevelopmental effects of early exposure to general anesthesia and examines a changing paradigm in the management of pediatric glaucoma.

Recent findings Literature across multiple subspecialties has examined the potentially neurotoxic effects of general anesthesia on the developing child's brain. Associations between general anesthesia exposure early in life and attention deficit hyperactivity disorder, language processing, and cognition have been suggested but not confirmed. Several population studies support the conclusion that early anesthetic exposure may increase the risk of neurodevelopmental deficits, although this is unsupported in sibling cohorts. Newer technology such as rebound tonometry may decrease the frequency of examination under anesthesia in the long-term management of patients with pediatric glaucoma and may decrease the risk of these potentially adverse neurodevelopmental outcomes.

Summary As the potential long-term adverse neurodevelopmental effects of general anesthesia become better understood, pediatric glaucoma specialists should be cognizant of the relative lifelong risks and benefits of repeat examinations under anesthesia in young patients.

Bascom Palmer Eye Institute, Miami, Florida, USA

Correspondence to Ta C. Chang, MD, Bascom Palmer Eye Institute, 900 NW 17th Street, 450N, Miami, FL 33136, USA. Tel: +1 305 326 6000; e-mail:

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins