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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

Where ophthalmic surgery is performed as a daycase procedure, the facilities should conform to best practice guidance. Day surgery operating theatres should meet the same standards as inpatient operating theatres.^24,25,26 Room should be available for patients to be seen in private by the anaesthetist and surgeon on the day of surgery.²There should...

In units where ophthalmic surgery is performed, including locations that may be isolated from main theatre services, facilities provided should allow for the safe conduct of anaesthesia and sedation. This would include monitoring equipment, oxygen, availability of opioid and benzodiazepine antagonist drugs, a recovery area, and drugs and equipment to deal with emergencies such as cardiac arrest, anaphylaxis and local...

All areas in which ophthalmic anaesthesia is performed should have a reliable supply of the medicines required to deliver safe anaesthesia and sedation. Storage arrangements should be such that there is prompt access to them if clinically required, maintains integrity of the medicines, and ensures compliance with safe and secure storage of medicines regulations.³¹ In addition, anaesthetists and...

Facilities should be available or transfer arrangements should be in place to allow for the overnight stay of patients who cannot be treated as day cases or who require unanticipated admission.

Optimal patient positioning is critical to the safe conduct of ophthalmic surgery and for patient comfort. Adjustable trolleys/operating tables that permit correct positioning should be available.³¹

Some patients, for example those with restricted mobility, may require specific equipment such as hoists to position them. Preoperative planning should ensure that such equipment is available and should allow for the extra time and staff needed to position these patients safely.

Very frail patients may not benefit from some types of ophthalmic surgery, and a conservative approach should be considered.²¹

Dementia is a growing problem; it is estimated there will be 1.5 million people in the UK with dementia by 2040. Evidence suggests there is a benefit in performing early cataract surgery in these patients, maximising cognitive improvement and minimising post-operative cognitive dysfunction.²¹