The consultants and specialty society members agree that
direct pressure on the eye should be avoided to reduce the
risk of CRAO and other ocular damage. The consultants and SNACC members agree that the patient’s head should be
positioned level with or higher than the heart in high-risk
patients; NANOS member opinion is split equally between
agree and equivocal, and NASS member opinion is split
equally among agree, equivocal, and no opinion. The consultants,
SNACC members, and NASS members agree that
the patient’s head should be placed in a neutral forward position
in high-risk patients; the NANOS members report no
opinion. The consultants, SNACC, and NANOS members
agree that the type of head positioning device is not associated
with perioperative ION; the NASS members disagree.
The consultants and all specialty society members agree that
the use of a horseshoe headrest may increase the risk of ocular
compression and perioperative CRAO. They all agree that
the eyes of prone-positioned patients should be assessed regularly
and documented. In addition, they all agree that perioperative
facial edema is common in high-risk patients.