A review of anesthesia for the open globe

There are many factors, both physiological and pharmacological, that influence IOP during anesthesia. The choice of anesthetic technique must consider factors other than IOP such as the patient's general condition, concomitant injuries, and the nature of the operation. At this time, there is no ultrarapidly acting neuromuscular blocking agent to allow succinylcholine to be completely abandoned and no method of succinylcholine pretreatment is completely effective in blocking the increase of IOP. The anesthesia provider must balance the overall risk to the patient with the risk to the injured eye when deciding if succinylcholine is to be used. The controversy regarding the actual risk that succinylcholine presents to the open eye has gone on for years and can be expected to continue.