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In isolated units, where no anaesthetist or medical emergency team is immediately available, there should be at least one person with advanced life-support training or equivalent.^2,9 A clear and agreed pathway should be in place for isolated units to enable the patient to receive appropriate advanced medical care, including intensive care, in the event of it being required.²

If no anaesthetist is present in theatre, an appropriately trained anaesthetic nurse, ophthalmic theatre nurse or operating department practitioner (ODP) should be present to monitor the patient during establishment of local anaesthesia and throughout the operative procedure. This should be their sole responsibility.²

Wherever possible, anaesthesia in remote ophthalmic surgical sites should be delivered by appropriately experienced consultant anaesthetists. Where a trainee or non-consultant grade is required to provide anaesthetic services at a remote site, the recommendations of the Royal College of Anaesthetists should be followed.¹⁰

If inpatients are cared for in isolated/single specialty units, there should be medical cover and nursing care appropriate to the medical needs of the patients.¹¹

Where inter hospital or intra hospital transfer is necessary, patients should always be accompanied by appropriately trained staff.¹¹

All members of clinical staff working within the recovery area should be certified immediate life support providers and mandatory training should be provided.^7,13

For children, staff should hold an equivalent paediatric life-support qualification.^7,13

Patients having ophthalmic surgery should undergo preoperative preparation, where there is the opportunity to assess medical fitness and impart information about the procedure.⁷

The patient must be made aware of alternative treatment options, or the option for no treatment at all. It is acceptable to recommend one of the alternatives but, as the GMC states: ‘The doctor may recommend a particular option which they believe to be best for the patient, but may not put any pressure onto the patient to accept their...

As part of preoperative preparation, the plan for the perioperative management of any existing medications, such as anticoagulant drugs and diabetic treatment, should be agreed, taking into account the relative risks of stopping any medication in the light of the patient’s medical condition and the anaesthetic technique required. Advice should be sought from the multiprofessional team (e.g. medical colleagues, clinical...