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Multidisciplinary quality improvement initiatives strengthen joint working and develop a cohesive working environment. Time should be set aside for regular joint governance meetings looking at both morbidity and quality issues.

Information about the different clinical management options should be discussed and suitable literature provided to assist patients in making an informed choice. The patient must have an opportunity to weigh up the available options.^52,54

Translations or interpreters should be made available if required.

Information should be made available to patients that gives details of the surgery and local and general anaesthesia for ophthalmic procedures, as well as advice on what to expect on the day of admission. The Royal College of Anaesthetists and the Royal College of Ophthalmologists have a range of booklets available on their websites to help to inform patients.^55,56,57

Written instructions regarding the plan for the perioperative management of existing medications, including if and when to stop anticoagulants, should be given to the patient.

Written information for patients should be easy to read. It should be available in an appropriate language and format for those patients who are visually impaired.^58,59 It may be necessary to provide translations of patient information booklets into languages suitable for the local population.

Patients having ophthalmic surgery should undergo preoperative preparation, where there is the opportunity to assess medical fitness and impart information about the procedure.⁷

Patients who require general anaesthesia or intravenous sedation should undergo preoperative anaesthetic assessment.⁷

As part of preoperative preparation, the plan for the perioperative management of any existing medications, such as anticoagulant drugs and diabetic treatment, should be agreed, taking into account the relative risks of stopping any medication in the light of the patient’s medical condition and the anaesthetic technique required. Advice should be sought from the multiprofessional team (e.g. medical colleagues, clinical...

The majority of ophthalmic surgery is performed as a daycase procedure under local anaesthesia.²² Preoperative assessment should identify those patients who are not suitable for this approach and who might require general anaesthesia or intravenous sedation.^2,23