Educational draft · awaiting clinical reviewUse Rapid for revision, not patient-care decisions. Check current national and local guidance and the BNF or BNFC before acting.
2 min synopsisUK scopeSources checked 7 Sept 2026Clinical review pending
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Intraocular gas and nitrous oxide
Nitrous oxide can enter an intraocular gas bubble, expand it and raise pressure enough to compromise retinal perfusion.
Action: Avoid nitrous oxide, including Entonox or Equanox, while intraocular air or gas remains. Tell ambulance, emergency, maternity, dental and anaesthetic teams about the bubble. If exposure occurs or severe pain and visual loss develop, stop the exposure and obtain immediate anaesthetic and ophthalmic assistance.
Synopsis
Explain the aims of retinal repair, distinguish surgical approaches and tamponade materials, and translate the operative plan into safe positioning, medication, travel and follow-up arrangements.
Vitrectomy removes vitreous to improve access, clear opacity and relieve traction; additional retinal treatment addresses the underlying lesion.
Scleral buckling supports a retinal break externally, while laser or cryotherapy creates a local adhesion around selected retinal pathology.
Gas, air and silicone oil have different persistence and follow-up implications and must be identified in the discharge record.
Key red flags
Increasing postoperative pain, redness or visual deterioration needs urgent contact with the retinal service to assess infection, pressure or recurrent detachment.
Investigation priorities
01
Preoperative retinal and visual assessmentFirst step
Define the surgical target, visual potential and relevant ocular risks.
Management branches
Before the operationMake the intended repair understandable
Retinal surgery is proposed for a defined structural or vitreous problem.
Explain the aim, alternatives, expected visual benefit and meaningful complications, including the possible need for additional operations.
Confirm ability to lie in the operative position and follow any likely postoperative posture, arranging adaptations and home support in advance.
National guidance is shown before implementation-dependent detail. Typical adult dose examples remain subject to patient factors, contraindications and the live BNF or specialist protocol. Source check completed 7 Sept 2026; clinical approval remains outstanding.