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Intermediate level training as set out in the RCoA 2010 Curriculum⁴¹should be an essential criterion and higher level training a desirable criterion in the person specification for a consultant or autonomously practising anaesthetist with ophthalmic anaesthetic sessions in the job plan. For candidates who are trained on the RCoA 2021 Curriculum, the special interest area in ophthalmic anaesthesia...

All anaesthetists working in ophthalmic services should have access to continuing educational and professional development facilities for advancing their knowledge and practical skills associated with ophthalmic anaesthesia.⁴⁴

All staff should have access to adequate time, funding and facilities to undertake and update training that is relevant to their clinical practice, including resuscitation training.⁴⁵

In single specialty centres, the anaesthetic department should adopt the generic standards described throughout GPAS. This should include a lead paediatric anaesthetist if children are treated.

All ophthalmic patients should receive the same standard of preoperative preparation, perioperative care and follow-up, regardless of the type of treatment facility.^6,24

Many procedures do not have to be performed out of hours.³⁵Anaesthetists and surgeons together should devise departmental protocols for the handling of patients requiring urgent procedures, to allow prioritisation from both surgical and anaesthetic perspectives.

Patients assessed to be at high risk of serious perioperative complications, such as a cardiorespiratory event, should be carefully stratified for surgical and anaesthetic requirements, and may be unsuitable for surgery in isolated units without immediate access to anaesthetic/medical cover.

The majority of patients are treated as day cases. Consideration should be given to prescribing suitable analgesics to take home; it may prove useful to use protocols to optimise treatment pathways.⁴⁶

National safety standards for invasive procedures should be adapted for local use as local safety standards for invasive procedures.⁴⁵ The WHO preoperative team brief and checklist system, for example, could be adapted to incorporate intraocular lens selection to help prevent ‘wrong lens’ errors.⁴⁷

There should be a procedure for checking the laterality of the eye to be operated on prior to local anaesthetic block or general anaesthesia. This should include the eye being marked with an indelible mark by the responsible surgical team prior to admission to the operating theatre. ‘Stop before you block’ protocols should be adhered to.⁴⁸Inadequately performed ‘sign-in’...