EXAMINATION UNDER ANESTHESIA (EUA)

Because a complete examination for retinoblastoma can be difficult for babies and young children, your doctor may recommend an Examination Under Anesthesia (EUA) as the best way to thoroughly examine your child's eyes. The EUA, may involve the following procedures:

• External examination of both eyes
• Internal examination of both eyes
• Drawings of the involved eye
• Photographs of both eyes
• Ultrasound
• Treatment procedures on the involved eye(s) such as cryotherapy or laser treatment
• Any necessary surgical procedures will be performed only after discussion with the family

Before your child undergoes an EUA your doctor may require a clearance for anesthesia from your children's pediatrician. Your doctor and hospital will give you complete instructions prior to the EUA, which probably will include no solid food for at least 8 hours before the procedure. Typically clear liquids (such as Gatorade, apple juice, grape juice, cranberry juice and water, but NOT milk or orange juice) may be given 6 hours before surgery, but after midnight, nothing to eat or drink.

Prior to the EUA, eye drops are administered to dilate the pupil. Because the eye drops sting (for about 30 seconds), your child may cry for a short time. Parents may want to help the nurses by holding the child still while the eye drops are given. This lets your child know that you are there. Usually after the eye drops are administered, the anesthesiologist will see your child and clear them for surgery.

After the anesthesiologist examines your child, your child will receive an injection to mildly sedate him or her. Typically a nurse will give this shot in your child's thigh about 10 minutes before your child goes to the Operating Room. Again, it is both helpful and comforting for you to hold your child while the shot is being administered. Once in the Operating Room, the anesthesiologist administers general anesthesia by placing a mask over the mouth or nose. Once the child is asleep, a tube may be placed in the throat to help regulate breathing.

When the procedure is finished, your child will be taken to the Recovery Room and remains there until fully awake. When you child returns from Recovery, he or she may be confused or upset. It is normal for a child to cry or be restless following an EUA. Many parents worry that the child is in pain. This is not usually the case. Generally, the child is reacting to the anesthesia wearing off, and your child may be a little disoriented during this time. Crying may actually assist in removing the anesthesia from your child's system and help make them more alert. The best thing you can do is to try to comfort your child and wait.

Following the EUA most children are either sleepy and/or hungry. If your child falls asleep, he or she may sleep for about an hour. If your child is hungry, you may offer clear liquids. Breast fed infants may be given breast milk.

Depending on what procedures are performed, your child usually will be ready to go home the same day. However, if any eye surgery is required, a night's stay in the hospital may be necessary. When your child is discharged, you will receive complete instructions and follow-up appointments.