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Eye operation tomorrow

Patricia Alice

Registered User
Mar 2, 2015
179
My 90 year old mum is due to have her entropian operated on tomorrow (it's where the lower lid is turning in and scratching the eye); she is in so much distress with it. The Consultant is also going to do her cataracts at the same time. Originally it was due to be done under a local anaesthetic but at the pre-op she became very agitated and so a general anaesthetic was decided.

Today my sister has gone into meltdown about the GA and worrying if she will survive it. I said she should have voiced these concerns at the pre-op two weeks ago and not the Sunday before the operation.

My poor mum is constantly pulling at the eye because it is irritating her so much.

I have said to my sister that it is also cruel to let her be in so much distress with it.

Now she has sown all these seeds of doubt in my head to. What do you do, what is the right thing to do?

Does anyone have any experience of eye operations on a dementia sufferer.

Now very confused at what is the best for mum.
 

Grannie G

Volunteer Moderator
Apr 3, 2006
71,130
Kent
If your mum is so distressed about both her discomfort and the operation I don`t see you have any choice other than go ahead with the surgery.

GAs are known to have detrimental effects on people with dementia but your mother sounds in so much discomfort with her eye condition now, I don`t see how it can be avoided.

The only compromise I can think of is perhaps the consultant would agree to a mild sedation pre op which might enable your mother to have a local anaesthetic.

There`s nothing constructive in your sister going into meltdown if she has no alternative to offer.

I do hope all goes well.
 

Patricia Alice

Registered User
Mar 2, 2015
179
If your mum is so distressed about both her discomfort and the operation I don`t see you have any choice other than go ahead with the surgery.

GAs are known to have detrimental effects on people with dementia but your mother sounds in so much discomfort with her eye condition now, I don`t see how it can be avoided.

The only compromise I can think of is perhaps the consultant would agree to a mild sedation pre op which might enable your mother to have a local anaesthetic.

There`s nothing constructive in your sister going into meltdown if she has no alternative to offer.

I do hope all goes well.
Thank you for your prompt reply.

I tried to say to my sister, if mum had fallen and broken her hip then they would have no choice but to operate on a GA.

I think your suggestion of a mild sedation and local is very helpful, and I will pose this question. I presume we get chance to talk with the anaesthetist beforehand?

Once again, Granny G. Thank you. x
 

fizzie

Registered User
Jul 20, 2011
2,730
I don't know if this is of any help but my Ma broke her femur and they promised a GA because I knew she wouldn't understand if they did a local. What did they do, a local! and she had a heart attack on the table (survived) because she didn't understand what was happening. i soooooo wish they had done a GA - it would have saved her so much distress. So just by my experience I would go for the planned but I am sure others will have different opinions. It will be great to have your Mum with no eye discomfort - I suffer with my eyes and it's awful!!!
Good luck tomorrow x
 

Patricia Alice

Registered User
Mar 2, 2015
179
I don't know if this is of any help but my Ma broke her femur and they promised a GA because I knew she wouldn't understand if they did a local. What did they do, a local! and she had a heart attack on the table (survived) because she didn't understand what was happening. i soooooo wish they had done a GA - it would have saved her so much distress. So just by my experience I would go for the planned but I am sure others will have different opinions. It will be great to have your Mum with no eye discomfort - I suffer with my eyes and it's awful!!!
Good luck tomorrow x
Thank you Fizzie.

This is exactly what I have said to my sister, if she had fallen and an operation was needed we would have no choice but to go ahead.

As it is now, she is nearly pulling her eyeball out at times and I think it must be so frustrating for her.

I am glad your mum is OK now. It is such a worry isn't it as they have no comprehension at to what is happening to them. My mum screamed when they took her blood at the pre-op.
 

Grannie G

Volunteer Moderator
Apr 3, 2006
71,130
Kent
I wouldn't presume anything . I would speak to the ward manager as soon as your mother is admitted and discuss the situation.
 

Selinacroft

Registered User
Oct 10, 2015
936
Hi
Dad has cataracts and says he doesn't want surgery- he can get by for now so I have not pushed the idea as he is 89 and fed up being in hospital for different things.
I haven't any experience of eye surgery in the elderly but Dad was 87 or 88 when he had to have a GA after breaking his tib and fib. It is always a worry when they are so old but I think there is not much choice if they need something important doing. Be led by medical advice and discuss your concerns with anesthetist . I am sure she will be ultra careful in monitoring your mum. Nothing at any age is guaranteed and if problems do occur don't beat yourself up over making the wrong decision. From what you say there is no decision to make and mum must have the eye op.
 

Torontonian

Registered User
Jan 29, 2014
57
Toronto, Ontario CANADA
Hi Patricia Alice,

My mom with dementia also had to have a eye surgery, corneal transplantation, and had to do it with GA. Our pre-op appointment was very stressful for her, and she was very agitated. Based on our behaviour that day and also realizing she may not follow instructions during surgery, they opted for the GA. During the operation she had a heart attack. After the operation she had delirium for a day or so and we were discharged the next day. This was a year and a half ago. She still lives with me. The surgery had to happen as her cornea was badly damaged and the stress of the pain and infections and not being able to see was causing her more agitation. So the end result was better. She was 89 at the time of the surgery.

Good luck with the operation and hope all works out for your mom.



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Patricia Alice

Registered User
Mar 2, 2015
179
Thank you all for your replies. I am worried, but I don't think we have a choice but to proceed for her longer term with no eye problems.
 

canary

Registered User
Feb 25, 2014
12,216
South coast
Mum, with mid-stage dementia, has just recently had a cataract op under local anesthetic. She found it pretty traumatic, but it went well with the nurse constantly reminding her what was happening and now she can see so much better, so I think it was definitely worth it. I dont think we'll get the other one done though.

I spoke to the surgeon before the op and asked him about having a sedation and he said that in his experience it made people with dementia more confused, so he didnt like using it.

Nothing is perfect when you are dealing with dementia - you just have to weigh up the pros and cons. If she cant cope with a local anesthetic (and it will take longer because she is having 2 procedures doing - mum wouldnt have been able to cope with that either) then you have to go for a GA. So the question is - does the risk of dementia progression outweigh the benefits of reducing the eye discomfort and visual improvement?

Edit to say, that I would go for the GA under these circumstances, but the decision is yours.
 
Last edited:

Patricia Alice

Registered User
Mar 2, 2015
179
Mum, with mid-stage dementia, has just recently had a cataract op under local anesthetic. She found it pretty traumatic, but it went well with the nurse constantly reminding her what was happening and now she can see so much better, so I think it was definitely worth it. I dont think we'll get the other one done though.

I spoke to the surgeon before the op and asked him about having a sedation and he said that in his experience it made people with dementia more confused, so he didnt like using it.

Nothing is perfect when you are dealing with dementia - you just have to weigh up the pros and cons. If she cant cope with a local anesthetic (and it will take longer because she is having 2 procedures doing - mum wouldnt have been able to cope with that either) then you have to go for a GA. So the question is - does the risk of dementia progression outweigh the benefits of reducing the eye discomfort and visual improvement?

Edit to say, that I would go for the GA under these circumstances, but the decision is yours.
Thank you Canary,

Since 7am this morning she has been in terrible discomfort. So we have to do it and hope beyond hope that it does not affect her dementia, but I think I can cope with that more than the constant references to her eye.

Fingers crossed for today
 

Selinacroft

Registered User
Oct 10, 2015
936
Thank you Canary,

Since 7am this morning she has been in terrible discomfort. So we have to do it and hope beyond hope that it does not affect her dementia, but I think I can cope with that more than the constant references to her eye.

Fingers crossed for today
Hi Patricia

Has your mum undergone the procedure today? I expect she will still be under the GA if she has , I remember it took a long time for Dad to come round as they do things slowly with patients of that age. Hope all has gone well.
 

Patricia Alice

Registered User
Mar 2, 2015
179
Hi everyone,

Sorry I have not got back on here sooner.

The OP did NOT TAKE PLACE, it was a very traumatic day for us all.

The anaesthetist would not put mum out as we do not hold Power of Attorney and my consent did not count. So after many hours of waiting around with her in her theatre gown, the op was cancelled by the anaesthetist.

We now have to have an MDT meeting with Safeguarding, Consultant, Anaesthetist, myself and my mum's CPN in her 'Best Interest' to say she has no capacity and therefore unable to consent herself to the operation.

Hopefully this will go ahead in January, but in the meantime my poor mum is in so much distress with her eye and nothing we as a family can do about it.
 

fizzie

Registered User
Jul 20, 2011
2,730
how awful for all of you. Is there nothing that the opthalmologist can give to relieve the pain and discomfort - i presume normal painkillers don't even touch it! I don't know how they can do this to people it seems so unkind
Thinking of you all xx
 

Slugsta

Registered User
Aug 25, 2015
2,761
South coast of England
What a horrible day, it must have been so distressing for both you and your mum! I do hope a satisfactory solution is found soon so that your mum is more comfortable. Would it be possible to use anaesthetic eye drops for the time being to keep the pain at bay?
 

Hannah5000

Registered User
Dec 26, 2015
3
Eye op experience

Hi,

My nana, who also sufferes from dementia recently underwent cataract surgery, while the op was a resounding success, there is no doubt it made life difficult for a week or two - she consistently complained about brightness and her glasses making her vision bad. We persevered and now things have greatly improved and we are considering the possibility of having her second eye operated on too.

I'm sure the experience will be equally difficult second time but hopefully as succesful.

We cannot change what is happening but we can do our best to improve quality of life while they can still be grateful.

I hope the operation is a success.
 

Patricia Alice

Registered User
Mar 2, 2015
179
how awful for all of you. Is there nothing that the opthalmologist can give to relieve the pain and discomfort - i presume normal painkillers don't even touch it! I don't know how they can do this to people it seems so unkind
Thinking of you all xx
Hi Fizzie,

Mum is on drops daily to try to relieve the irritation in the eye but sadly it does absolutely nothing, the only thing that will help is to operate on the entropian to stop the eye turning in on itself and scratching the eyeball.

I am afraid we have to persevere until the meeting and if I have not heard by the second week on January I will be chasing them.

Happy New Year x
 

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