OCULOCARDIAC REFLEX

Course overview

THE OCULOCARDIAC REFLEX (OCR), ALSO KNOWN AS THE ASCHNER REFLEX OR TRIGEMINOVAGAL REFLEX (TVR), WAS FIRST DESCRIBED IN 1908 AS A REDUCTION IN HEART RATE SECONDARY TO DIRECT PRESSURE PLACED ON THE EYEBALL. IT IS DEFINED BY A DECREASE IN HEART RATE BY GREATER THAN 20% FOLLOWING GLOBE PRESSURE OR TRACTION OF THE EXTRAOCULAR MUSCLES. THE REFLEX MOST COMMONLY RESULTS IN SINUS BRADYCARDIA. HOWEVER, IT ALSO HAS A REPORTED ASSOCIATION WITH REDUCED ARTERIAL PRESSURE, ARRHYTHMIA, ASYSTOLE, AND EVEN CARDIAC ARREST. THIS REFLEX HAS MOST NOTABLY BEEN DEPICTED DURING OPHTHALMOLOGIC PROCEDURES, MORE SPECIFICALLY DURING STRABISMUS SURGERY; HOWEVER, IT ALSO MAY BE ACTIVATED BY FACIAL TRAUMA, REGIONAL ANESTHETIC NERVE BLOCKS, AND MECHANICAL STIMULATION. THIS ACTIVITY DESCRIBES THE OCULOCARDIAC REFLEX AND HIGHLIGHTS THE ROLE OF THE INTERPROFESSIONAL TEAM IN THE MANAGEMENT OF PATIENTS WITH THE SYMPTOMS DURING SURGERY.