If the clinical findings are limited
to the eye, no specific considerations arise from this syndrome, except use
of an anesthetic technique that does not cause further increase in
intraocular pressure in patients with glaucoma. In contrast, some patients
have cardiomyopathy, tetralogy of Fallot, generalized hypotonia, and
scoliosis. Preoperative echocardiography is recommended to determine the
lesions and their hemodynamic significance. The presence of Wilms tumor
requires further diagnostic measures, such as abdominal ultrasound, CT
scanning, and/or MRI. Preoperative blood workup should include a complete
blood count (anemia), electrolytes, and assessment of renal function
(creatinine, BUN). Mental and neurologic status (decreased vision/blindness)
must be assessed for a thoughtful approach to premedication and induction.