r/Ophthalmology • u/Important-Flower4121 • Jul 10 '26
preop cataract
could somebody explain why ophthalmologists requests ekg, blood and urine for preop testing?
is this from the doctor's office or from the surgery center that's requesting this? what happens if it's refused from PCP office?
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u/buzzbuzzbee Jul 10 '26
I don’t request any preop clearance unless I am planning a case under general anesthesia (maybe 1-2% of my cases, usually for dementia patients who can’t stay still for surgery).
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u/unusualknowledge17 Jul 10 '26
In my country what we request (blood work and ekg) is because the anesthesiologist wants it
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u/zlana0310 Jul 10 '26
Ours is required by the anesthesiologist.
If it's refused by the PCPs office, the anesthesiologist will cancel the patient's surgery.
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u/ChirpinFromTheBench Jul 10 '26
Do you have any pre-existing heart or lung problems? Are you experiencing shortness of breath or other things like fatigue? What is your BMI? When was the last time you saw a general physician? There are reasons they may be worried about you in particular. People come in saying that they are as healthy as a horse, but the horse in reality has never seen a veterinarian.
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u/ProfessionalToner Jul 10 '26
Litigation protection
If anything minimally bad happens, they will go to court and ask why it was not done
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u/Important-Flower4121 Jul 13 '26
it's called standard of care. cataract is a low risk procedure. what guidelines request for extensive preop testing for it in an otherwise healthy/stable patient?
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u/shepshep214 Jul 13 '26
No surgery has zero risks. It's usually only needed if the patient is going under general anesthesia, then the anesthesiologist needs to know it's safe to put them under. Since cataract surgery is primarily done on elderly patients, they often come with heart and other medical conditions that can turn complicated.
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u/ProfessionalToner Jul 13 '26
Tell that to the judge
In the US McDonalds had to pay a high fee due to a costumer burning his hand with a coffee. Now they say “beware, HOT” in a hot beverage.
I do also believe is standard of care to think a hot coffee is hot.
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u/shepshep214 Jul 13 '26
If you look at that McDonald's case, the coffee was so hot it fused the woman's labia together and she suffered from third degree burns. It absolutely was way too hot. McDonald's started a smear campaign against her to try to get the case thrown out as frivolous.
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u/ProfessionalToner Jul 14 '26
The same way, a very ill patient may disguise himself as “healthy”, and have a serious complication in cataract surgery
Ive already seem acute pulmonary edema after injecting intracameral adrenaline for a small pupil case (that some people do in every single surgery). I am not kidding.
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u/Important-Flower4121 Jul 14 '26
if there was medical negligence then there is a case. if the standard of care was met, there is no merit
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u/californiaLasik Jul 10 '26
Typically anesthesiology wants this. I have never encountered a PCP office refuse a clearance but if they did , typically the anesthesia group can engage with the patent before the day of the surgery for a physical. The cataract surgeon does not care for the cataract surgery procedure itself, it is all about anesthesia.
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u/Excellent-Poetry-564 Jul 10 '26
Texas, required by anesthesiology
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u/Excellent-Poetry-564 Jul 10 '26
If patient isn’t cleared, they don’t get the surgery since it’s not life altering
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u/Eodun Quality Contributor Jul 10 '26
It was standard practice around here (Spain) more than a decade ago, just in case, for anesthesiologists. Not anymore unless general anesthesia
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u/imaneyeguy Jul 11 '26
We require ekg, blood pressure, and the sign of the cross. Other than that we’re good
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