• American Academy of Ophthalmology
    Cataract/Anterior Segment, Comprehensive Ophthalmology, Cornea/External Disease, Glaucoma, Neuro-Ophthalmology/Orbit, Ocular Pathology/Oncology, Oculoplastics/Orbit, Pediatric Ophth/Strabismus, Retina/Vitreous, Uveitis

    In response to the current COVID-19 pandemic, ophthalmologists have requested a master list of procedures that are generally performed in operating rooms at hospitals or ambulatory surgery centers as “urgent” or “emergent” procedures. 

    The American Academy of Ophthalmology has collated these procedures, along with their more common likely indications, into this single list. This list is not meant to cover all indications or all potential procedures but to include those, in the opinion of the major subspecialty societies listed, that are more commonly performed by ophthalmologists in practice.

    The Academy thanks the following societies for their substantive contributions to this list:

    • American Association of Ophthalmic Oncologists and Pathologists
    • American Association of Pediatric Ophthalmology and Strabismus
    • American Glaucoma Society
    • American Society of Ophthalmic Plastic and Reconstructive Surgery
    • American Society of Retina Specialists
    • Cornea Society

    For additional information visit the Academy's resource page Coronavirus and Eye Care.

    Urgent and emergent surgical procedures

    Surgical Procedure
    Indications

    Biopsy of orbit

    Suspected malignancy or immediate sight-threatening condition

    Biopsy of temporal artery

    Suspected giant cell arteritis

    Brachytherapy

    Intraocular malignancy

    Cantholysis

    Sight-threatening conditions

    Canthotomy

    Sight-threatening conditions

    Cataract surgery

    Congenital cataract in the amblyopic period, monocular patients with documented vision loss precluding driving, reading or self-care, lens-induced glaucoma, angle-closure glaucoma, acute lens complications, or severe anisometropia of fellow eye post recent lens extraction in first eye

    Closure of cyclodialysis cleft

    Sight-threatening hypotony due to trauma

    Corneal transplantation

    Pediatric patients with corneal blindness in both eyes in their amblyopic period

    Decompression of dacryocele

    Neonate with obstructive respiratory compromise

    Decompression of orbit

    Orbital tumor with impending vision loss

    Drainage of abscess

    Orbital cellulitis

    Drainage of choroidals

    Appositional choroidal effusion, suprachoroidal hemorrhage, or flat anterior chamber

    Enucleation

    Ocular trauma, infection, intractable glaucoma, globe perforation, intractable pain, or intraocular malignancy

    Evisceration

    Sight-threatening infection, or intractable pain

    Examination under anesthesia

    Pediatric patients with retinoblastoma, endophthalmitis, Coats Disease, uveitis, glaucoma, ocular trauma, retinal detachment, or presumed intraocular foreign body

    Excision of tumors

    Malignancy or sight-threatening tumor

    Exenteration

    Life-threatening infection

    Exploration of orbit

    Life-threatening or sight-threatening conditions

    Fenestration of optic nerve sheath

    Progressive vision loss

    Filtration surgery (XEN45 gel stent)

    Uncontrolled intraocular pressure that is sight-threatening who are poor candidates for trabeculectomy or aqueous tube shunts

    Frontalis sling

    Sight-threatening congenital ptosis

    Goniotomy ab externo or ab interno

    Uncontrolled intraocular pressure that is sight-threatening

    Insertion of drainage implant with or without graft

    Catastrophic or rapidly progressive glaucoma

    Laser indirect retinopexy – complex

    Retinal detachment, retinal tear, or ocular trauma

    Laser photocoagulation

    Pediatric patients with retinopathy of prematurity (if this can’t be in NICU)

    Pars plana lensectomy

    Acute lens complications

    Peeling of membrane/internal limiting membrane

    Proliferative diabetic retinopathy, proliferative vitreoretinopathy, complex preretinal membrane, or complex macular pathology

    Pneumatic retinopexy

    Retinal detachment

    Probing of nasolacrimal duct

    Dacryocystocele

    Reconstruction of ocular surface or other tectonic procedures

    Acute chemical injury, or acute Stevens Johnson Syndrome

    Removal of aqueous drainage implant

    Endophthalmitis, corneal touch, corneal decompensation, or exposed plate

    Removal of intraocular foreign body

    Presumed intraocular foreign body

    Repair of anterior segment or cornea

    Lacerations, blunt rupture, or deeply embedded corneal foreign body

    Repair of canalicular laceration

    Injury or trauma to their canaliculus

    Repair of dehiscence of corneal graft or other anterior segment wound

    Wound dehiscence or other wounds, including dislocated LASIK flaps

    Repair of extrusion or complication of keratoprosthesis

    Complications with implanted devices in their cornea or anterior segment

    Repair of eyelid/face

    Lacerations of eyelid or face

    Repair of facial fractures

    Displaced facial bone fractures

    Repair of open globe

    Ocular trauma

    Repair of operative wound(s)

    Bleb leaks, wound leaks, overfiltration, underfiltration, bleb scarring, sight-threatening hypotony, or shallow anterior chamber

    Repair of orbital fracture

    Hemodynamic instability or oculocardiac reflex

    Repair of perforation or impending perforation of cornea or sclera

    Corneal and scleral injury or trauma

    Retrobulbar injection

    Pain due to ocular diseases causing significant compromise of quality of life

    Revision of drainage implant with or without graft

    Implant/tube exposure that might be sight threatening, endophthalmitis, malpositioned tube endangering eye or excessive inflammation, a tube that might worsen vision due to corneal edema or iritis or cystoid macular edema, or with a severe tube malposition causing rapid visual loss

    Scleral buckle

    Retinal detachment, ocular trauma, intraocular infection, vitreous hemorrhage, retinal tear, or intraocular foreign body

    Strabismus surgery

    Torn or lost extraocular muscle

    Synechiolysis

    Lens-induced glaucoma or angle-closure glaucoma

    Tarsorrhaphy

    Impending corneal compromise

    Trabeculectomy with or without scarring

    Catastrophic or rapidly progressive glaucoma and markedly elevated intraocular pressure, or uncontrolled secondary or primary glaucoma

    Trabeculotomy

    Uncontrolled intraocular pressure that is sight-threatening

    Transscleral cyclophotocoagulation

    Uncontrolled glaucoma or absolute glaucoma with a blind and painful eye

    Vitrectomy

    Retinal detachment, ocular trauma, intraocular infection, vitreous hemorrhage, retinal tear, intraocular foreign body, misdirected aqueous, ciliary block glaucoma, malignant glaucoma, a vitreous prolapse, or a tube shunt that blocks filtration

    Washout of the anterior chamber

    Hyphema that is sight-threatening