Prevalent attitudes regarding residency training in ocular anesthesia

To determine the current level of formal training in ocular anesthesia provided to nonophthalmologist physicians, the rationale for this training or lack thereof, and the perceived need for this training by anesthesia residency training programs.

A two-page survey questionnaire was forwarded to all residency directors of ophthalmology and anesthesia training programs listed with the American Medical Association. A second mailing followed 2 months after the initial mailing if no response was received from a particular program.

An overwhelming response of 92% of ophthalmology programs and 76% of anesthesiology programs was achieved. In 93% of ophthalmology programs and 77% of anesthesiology programs, no formal training was provided to nonophthalmologist physicians in retrobulbar or peribulbar anesthesia. In addition, 78% of ophthalmology and 65% of anesthesiology programs denied having any plans to provide this training even though 40% of the anesthesia departments wanted to initiate and coordinate such training.

Currently, few ophthalmology programs offer formal training to anesthesiology residents in ocular anesthesia. Following are the predominant factors involved in this decision: (1) the operating surgeon is ultimately responsible for any complications; (2) there is a lack of knowledge of orbital anatomy and axial eye length by anesthesia personnel; and, most importantly, (3) there is a brief episodic nature in which anesthesia residents encounter ophthalmologic procedures resulting in minimal opportunities for training and experience from which the residency training program could ensure quality outcome and proper credentialling.