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Can a Jewish Surgeon do eye-surgery on Shabbos
in a Case of Emergency?

1 Questions
CIRCUMCISION ON A
BABY WITH AN EYE Question 1
103 INFECTION In ophthalmology there are several cases that would require urgent
surgery, mainly the situations listed below:

1. Endophthalmitis is a severe infection and inflammation of the
eye, which generally appears after surgery or trauma. This is the
1 Question CiRcuMcision with an Eye Infection most serious complication after surgery on the eye and every
physician fears it. The treatment is removal of the urea from

Every once in a while, I am called to examine a baby with an eye within the eye, the application of antibiotics into the eye, with
infection and ascertain whether it is permissible to perform circum- or without a vitrectomy to clean out the infection from the in-
cision. An examination of the baby gives me the impression that it side of the eye.
is a lachrymal gland infection (an external and pain-free infection), 2. Detachment of the retina, which endangers the macula, the cen-
which is not associated with a general illness. Once the baby responds ter of the retina which allows us to read and to recognize colors.
positively to treatment, I believe the circumcision could be performed When it is still attached, the surgery is to instill gas into the
as soon as the infection is healed. eye together with treatment either by cryotherapy (freezing) or
In the past, it was common for newborns to develop acute eye laser surgery or surgery to repair retinal detachments by sewing
infection transmitted from the mother during birth. Nowadays, in a flexible band of silicon around the eye.
order to prevent such infections, every newborn is given a drop of 3. A penetrating wound, with or without a foreign body in the eye.
silver nitrate immediately after birth. There is no doubt that before Surgery includes first hand repair of the wound and removal of
this form of preventative treatment became known, there was no way the foreign body as required
to perform circumcision with an eye-infection. There are also various
types of eye infections. Delay in performing surgery in these cases, even for only a few
I would be thankful if the honored Rav would answer this ques- hours, is liable to worsen the situation in the eye and to result in a
tion: What is the source for the prohibition of circumcising a baby less than perfect outcome, even after successful surgery. In the case of
with an eye infection, and which infection does the prohibition refer severe endophthalmitis, delay in surgery is likely to endanger the eye
to? and to cause loss of vision and even loss of the eye.
In view of the above, is it permitted to perform surgery in such cases
Dr. P. Nemet, on Yom Kippur, or on Shabbos, being that according to the physicians,
Ichilov Medical Center, Tel Aviv these situations endanger the organ but are not pikuach nefesh?

280 1 Medical-HalacHic Responsa of Rav ZilbeRstein Shabbos in an Ophthalmology Department 2 301

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