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Objectives Assessment of the impact of general anaesthetic agents on intraocular pressure (IOP) in children via systematic review. Methods Pubmed, Embase, and CENTRAL databases were systematically searched to identify randomised controlled trials, prospective, and interventional studies. The search included all studies through October 5, 2018 with no date or language restrictions. A linear mixed-effects regression analysis was performed to study the change in IOP after general anaesthesia (GA). ResultsThe strategy identified 518 studies that met search criteria. Six studies (531 eyes) were included for quantitative synthesis. Seven categories of mixed and non-mixed induction and maintenance agents were compared. When assessing all agents utilising a model of mean IOP as a function of time, IOP decreased after induction phase at a rate of −0.59 ± 0.19 mmHg/min (P value = 0.006). Conclusions This systematic review showed that most anaesthetic agents significantly decrease IOP over time after the induction phase of general anaesthesia in children. An understanding of the effects of GA on IOP is critical for those performing paediatric ophthalmic examinations under anaesthesia.

A 47-year-old Thai man, who had recently been diagnosed with active pemphigus vulgaris (PV) and treated with oral prednisolone together with intravenous dexamethasone, presented with severe ocular pain and light perception vision of the left eye for 4 days. Ophthalmic examination revealed periorbital soft tissue swelling with marked intraocular inflammation in the left eye. Severe panophthalmitis was diagnosed. Enucleation was performed after failure of intravenous antibiotics administration. Vitreous culture revealed Aeromonas hydrophila but no primary source of infection was clearly identified. An immunocompromised status accompanied with corticosteroid treatment is a risk factor for septicemia. A. hydrophilapanophthalmitis was detected in the PV patient, and this organism caused a rapid disease progression with poor visual prognosis.