Taking consent is a common examination question. It is key to avoid medical jargon and have a structured format. The following format (“YMCA”) is often useful to use as a template when consenting a patient:

Y (Why Have the Procedure)

Explain the disease pathophysiology and how the proposed intervention alters this. What are the expected benefits?

M (Mechanism, What is the Procedure)

  1. What is involved (draw a diagram)
  2. Duration
  3. Anaesthetic considerations: Local anaesthetic (LA) vs. General anaesthetic (GA)
  4. Pre-operative preparation: Fasting,  stop anticoagulants, optimise diabetes
  5. Post-operative expectation: Need for admission, dressings, eyedrops, follow-up

C (Complications)

  1. Most common
  2. Most important (including anaesthetic-related)

Provide contact details and a plan for patients if they have post-operative concerns.

“I will give you my contact details if you have any problems”.

A (Alternatives)

  1. Observation (describe the natural history of the condition)
  2. Medical therapy
  3. Other operations

(Extra Questions)

  1. Allergy
  2. Pregnancy

Special Considerations in Pregnancy


A. Drops

  • Refer to pharmacopeia regarding safety in pregnancy
  • Punctal occlusion (manual and / or plugs)


B. Surgery

  • Anaesthetic issues
  • Posture (especially in third trimester)
  • Greater risk of suprachoroidal haemorrhage: Use AC maintainer, tight sutures


C. Consult with Anaesthetist / Obstetrician

Confirm that the patient understands. Any questions?

          

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Vitreoretinal Surgery Online
This open-source textbook provides step-by-step instructions for the full spectrum of vitreoretinal surgical procedures. An international collaboration from over 90 authors worldwide, this text is rich in high quality videos and illustrations.

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