Been a good day so far. Afternoon teaching was cancelled (we were told to do self-directed learning ... like that was gonna happen!) so I have time to catch up on paperwork. Have an eye list tomorrow morning, hopefully it's all cataracts so I get to practice my sub-tenon blocks.
Couldn't find any colour pics of sub-tenons, but these show the 3 main steps quite well: (1) make a small cut in the conjunctiva, (2) slow dissection under Tenon's capsule down around the globe, (3) insert blunt cannula thru the tract you've made [while holding bit of conjunctiva] and inject local anaesthetic mixture when you've curved round the globe [I inject 4-5 ml of a 7ml solution containing Lignocaine 2% 3ml, Bupivacaine 0.5% 3ml and Hyaluronidase 150 IU/ml 1ml]. This is all done in an awake patient after topical anaesthesia with Tetracaine and Oxybuprocaine.
Going home to Malaysia this Friday (landing on Saturday morning). Apart from a short 3 days in January, this'll be my first trip in 16 months. Too long for someone who usually averages 2 trips a year. First stop is KL on Saturday for a bit of 'merry-making'. My next post will be after I recover from my hangover.
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