Modern surgical techniques allow many eye operations to be done as day surgical procedures. To facilitate this and to reduce the risks associated with anaesthetics, most eye operations are done awake, under local anaesthesia with appropriate sedation.
There are several techniques for providing local anaesthesia to the eye. These include topical anaesthesia, peribulbar block and subtenons block anaesthesia. Topical anaesthesia is best suited to superficial operations that do not require the eye to be immobile, such as some cataract operations. More commonly, eye surgery is done under a block anaesthetic. This gives excellent pain relief and an immobile eye for optimal surgical conditions. Whilst the thought of having eye surgery whilst awake may be difficult, your anaesthetist is there to help and patient satisfaction with the process is very high.
You will be admitted to hospital by one of the nurses and prepared for surgery. About this time, your anaesthetist will meet with you to discuss any health issues. You will be then placed on a bed and prepared for anaesthesia. Vital signs will be monitored, an oxygen mask applied and an intravenous cannula will be inserted. As the injection of local anaesthetic around the eye may be uncomfortable or upsetting, it is common for your anaesthetist to give sedation at this point. Your anaesthetist will then inject the local anaesthetic around your eye. A few minutes later you will wake up, your eye will be numb and taped closed. You will then be taken into the theatre for the operation.
During the operation, the anaesthetist will continue to monitor you for any rare but potentially dangerous complications.
After the surgery is finished, your anaesthetist will transport you to recovery and perform a clinical handover to recovery staff before you receive a snack and discharge.
Cataract surgery is not normally painful and a routine dose of paracetamol should settle any grittiness. If you have severe pain, you should contact your surgeon as occasionally complications can arise that cause increased pressure and pain in the eye.
Some other eye operations may be painful and in these circumstances you may be given a discharge script for pain killers.
These days, most eye operations on adults are done under local anaesthesia as this is much safer for patients who may have other health issues. Local anaesthesia has less complications and produces excellent post operative pain relief and allows a timely discharge from hospital by avoiding general anaesthesia reducing nausea and excessive sedation.
The risks from local anaesthesia relate mainly to the injection site. These include bleeding, infection or damage to the eye. Minor bruising may occur especially for those patients on blood thinners. Occasional unexpected reactions may occur.