2020–2021 BCSC Basic and Clinical Science Course™
11 Lens and Cataract
Chapter 12: Preparing for Cataract Surgery in Special Situations
Psychosocial Considerations
Claustrophobia
Patients with claustrophobia may find it helpful to be given details about the operating room and sterile-draping requirements prior to surgery. The medical team can make accommodations for a patient who becomes anxious and extremely uncomfortable when confined to a small space or when covered by a surgical drape over the head. The anesthetist can titrate intravenous sedation and hold the patient’s hand to provide comfort and reassurance. When feasible, the surgeon can supplement topical or local ocular anesthesia with soothing vocal support (ie, a “vocal local”). Options for reducing the sensation of claustrophobia and avoiding retention of carbon dioxide under the drape include placing a suction catheter under the drape, tenting open the side of the drape, or placing an elevated Mayo stand over the patient’s torso. Using a transparent drape also can help mitigate claustrophobia. General anesthesia can be given when these measures are not adequate.
Excerpted from BCSC 2020-2021 series: Section 11 - Lens and Cataract. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.