PREPARE YOUR CHILD FOR THEATRE


Surgery of any type can be daunting for both parents and children, sometimes causing much anxiety and uncertainty. The following information will give you an idea of what to expect and hopefully, put your mind at ease.

There are many reasons why a child might require eye surgery, for example:
  • Cataracts
  • Glaucoma (high pressure in the eye)
  • Watery eyes
  • Trauma
  • Probably the most common isstrabismus (misaligned eyes)
PRIOR TO A SURGERY
Once a date has been set for the surgery, our ophthalmology practice will send you an email with the following information:
  • Codes that the medical aid requires
  • The consent form for surgery
  • Information about the procedure that is going to be carried out

Your responsibilities are the following:
  • Acquire authorization from your medical aid and ensure that you find out exactly what is covered.
  • Submission of the authorization number along with the signed consent form to us to confirm the surgery.
Our paediatric anaesthetists will try to contact you the night before surgery to go over any medical history or concerns that you may have. They will also remind you of what your child can and cannot do before surgery, such as eating or drinking.


ON THE DAY OF THE SURGERY
On the day of the surgery your child will be admitted to a hospital. The admission is usually just for the day and your child can go home after the surgery. Occasionally, the surgeon or anaesthetist may feel that there is a need for your child to stay overnight, in which case their progress will be assessed the following morning and the appropriate decision made.

You will need to be at the hospital at least 2 hours before the procedure to complete all the necessary admin forms. From here you will then go to the ward.
In the ward your child will be assigned to a bed and is given a hospital gown and a theatre cap. It is a good idea to bring along one of their favourite games or an ipad to keep them entertained. It is normal for small children to be irritable. This is because they are hungry and in a strange environment. It may be tempting to want to ease your child’s discomfort by giving them something to eat or drink, but it is very important to abide by the anaesthetist’s recommended starvation rules as this is for the safety of your child.

Prior to surgery, your child’s physiological well-being will be monitored by a nurse in the ward. Your child’s weight, temperature, blood pressure and pulse will be measured (vitals). These are non-invasive procedures and should not hurt.

GOING TO THE OPERATING THEATRE
In our practice one parent is usually allowed to accompany a child over 3 months of age into the operating theatre and remain with them until they fall asleep. This is however left up to the discretion of the anaesthetist as to what they feel would be in the child’s best interest.

Young children are usually sedated with a breathing mask held over their face. Only once they are asleep and feel no pain, will an intravenous (iv) line and breathing tube be inserted.

Once any surgery is completed, your child will be given pain relief medication and sometimes, anti-nausea medication. They are then transferred to the recovery room. Here they will be monitored closely to ensure that they can be safely sent to the ward. As your child starts to wake up, you will be invited to join your child. This can be a distressing time for both you and your child, as they may be disorientated and irritable from being under anaesthesia.

EYE MUSCLE SURGERY IS THE MOST COMMONLY PERFORMED PAEDIATRIC OPHTHALMOLOGY PROCEDURE.
Despite common misconceptions, the eyeball is not removed or taken out of the eye socket; it is simply rotated into its actual position.

A small instrument called a speculum is used to keep the eyelids open. Small incisions are then made through a clear tissue (conjunctiva) that lies on top of the white part of the eye to minimize scarring. The muscles are then located and adjusted accordingly. The small incisions are then closed using dissolvable stitches. The entire surgical procedure usually lasts between 30-60 minutes.

IN THE WARD (POST-SURGERY)
Once your child is fully awake, the following conditions must be met before they can be discharged:
  • Their vitals are stable
  • They have had something to eat or drink
  • The nurse is satisfied that it is safe for them to go home
Before you leave the hospital: You will be given some eye medication. This will most likely include an antibiotic-steroid eye drop, ointment and analgesia. Ensure that you have a date for the follow up appointment in the rooms.

AT HOME (POST-SURGERY)
Every child is different and reacts to surgery differently. Some children will be up and playing as usual on the same day, whilst others will sleep a lot. Some kids will find it painful.

There are several issues that your child may battle with post operatively, such as:

Pain – In regard to pain, remember to follow the anaesthetist’s advice about giving painkillers at the correct times. Ice packs or a cold clean cloth placed over the eye can also help
Scratchy eyes - A scratchy sensation in the eyes is normal and should go away with the installation of the drops and ointment over the next fewdays.
Pink tears - Pink tears or a small amount of blood coming from the eyes is also, quite normal. These should stop over the next day or so.
The eye/s may appear slightly red or pink – This will resolve in one or two weeks
The eyelids may swell slightly –This will resolve over a couple of days
Bruising around the eye could occur –This should resolve over a couple of weeks
The stitches that were placed usually dissolve by about six weeks and a final result is obtained by 8 weeks.
THINGS NOT TO DO AFTER SURGERY
  • Ensure that your child does not rub their eyes. Rubbing puts a great deal of pressure on the eye and can adversely affect the surgical result
  • Do not allow your child to swim for at least ten days following surgery
  • Follow the post-surgery instructions given to you by your doctor
When should you be concerned?
  • Excessive pain not relieved by painkillers
  • Increased swelling of the lids
  • Increased redness of the eye over a few days
If you are concerned about the above or anything else after surgery, please contact us or present to your nearest emergency hospital unit.

Young children usually bounce back quickly after eye surgery and most will feel like themselves the very next day!

We hope that your child’s surgical journey is a positive one. Should you have any queries in relation to this topic, please do not hesitate to contact us.
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Busamed Modderfontein Private Hospital Orthopaedic & Oncology Centre
4 Cransley Crescent, Long Lake, Sandton, 2090 | Tel: / or

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