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Is Cataract Surgery Painful?

What if I am nervous or claustrophobic?

There are generally three anesthesia options for cataract surgery. Your best choice for anesthesia will be determined by your doctor, considering your particular needs and requirements. The three options include:

  • Topical anesthesia
  • Regional or Block anesthesia
  • General anesthesia

Topical Anesthesia:
With topical anesthesia numbing drops or gel are placed on the surface of your eye. In many cases oral or intravenous sedation is also given to make the experience more comfortable. The majority of cataract surgery done in the United States is performed under topical anesthesia. Most patients have a good experience with no significant pain and in many cases being so comfortable and relaxed that they take a short nap during the procedure.
Benefit: Topical Anesthesia is the safest form of anesthesia because no sharp needles are used around the eye and there is low stress on the body compared to general anesthesia.
Possible Negatives: With local anesthesia the eye can still move and a patient may see colors and shadows moving and in rare cases experience minor discomfort.

Regional Anesthesia:
With regional anesthesia a needle is used to inject anesthetic solution around the eyeball. This was the most common form of anesthesia for cataract surgery over the last 15 years, before topical anesthesia became common.
Benefit: The eye will see no lights or movement, move unexpectedly during the surgery, or feel any pain or discomfort.
Possible Negatives: in rare cases the optic nerve or other sensitive structures around the eye can be injured by the needle, the injection can cause bleeding behind the eye that can lead to post-operative problems, and a patch will need to be worn for the first day after the surgery completely covering the eye and vision.

General Anesthesia:
With general anesthesia you are completely put to sleep using strong anesthetic medications. A tube will be put in your mouth or throat to protect your breathing. This is the least common method of anesthesia for cataract surgery. It is generally reserved for patients who have movement disorders, children who may be unable to lie still during a cataract procedure, or an extremely claustrophobic patient.
Benefit: complete unawareness of the procedure.
Possible Negatives: highest risk for patients with significant medical problems, which in rare situations could lead to hospitalization. With general anesthesia you typically feel more groggy and some patients experience nausea.

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