Patient education: Anesthesia for elective eye surgery (The Basics)

What is elective eye surgery? — "Elective" means surgery that a person chooses to have. A common example of elective eye surgery is a procedure to treat cataracts. (A cataract is clouding of the lens in the eye. It can cause vision problems.)

Elective eye surgery is different from urgent or emergency eye surgery. That is surgery that must be done quickly. An example is surgery to treat an eye injury.

What is anesthesia? — "Anesthesia" is a medical term for different types of medicine people get before and during surgery or another procedure. These medicines are given so you do not feel pain or distress during the procedure. In some cases, like when you are "put to sleep" for surgery, the anesthesia medicines also prevent you from remembering it afterwards. In other cases, only mild "sedatives" are needed along with numbing medicines in the eye area.

Anesthesia medicines are given by a doctor called an "anesthesiologist" or another anesthesia provider such as a "nurse anesthetist".

What will happen before my surgery? — Your anesthesia provider will explain the steps that will happen during your surgery. You will also get instructions about:

●Whether you should stop taking any of your medicines ahead of time

●When to stop eating and drinking before your surgery

The anesthesia provider will talk to you about your options for anesthesia. This will depend on the surgeon's needs and the type of procedure you are having. They will also:

●Make sure that you are able lie still and follow instructions during the surgery

●Ask questions about your health conditions, past surgeries, and the medicines you take

●Examine your eyes, mouth, and throat

●Answer any questions you have

What type of anesthesia will I get? — Your options will depend on what type of eye surgery you are getting. Each type of anesthesia comes with its own risks and benefits. Your doctor will talk to you about how each type works and what to expect.

Your options might include:

●Local and regional anesthesia – This type of anesthesia is often used for surgery to treat cataracts or glaucoma. Medicines are used to numb your eye so you don't feel pain.

Eye drops or gel might be put on your eye. Then, you might get more numbing medicine through an injection (shot) near the eye. This is called regional anesthesia or an "eye block." The injection blocks pain, but also prevents you from moving your eye during surgery. This is often done if your doctor needs your eye to stay completely still during surgery.

Before the shot, you will probably get medicines called "sedatives." These make you relax and feel sleepy. They are given through a thin tube that goes into a vein, called an "IV."

●General anesthesia – This type of anesthesia makes you unconscious so you can't feel, see, or hear anything during surgery. Some of the medicines are given through an IV. Others are gases that you breathe in. You might also get a tube to help you breathe during the surgery. If this happens, the anesthesia provider will carefully place the tube in your throat after you are asleep during general anesthesia. They will remove the tube before you wake up.

General anesthesia is not commonly used for elective eye surgery in adults. But it might be used for children who need eye surgery. It can also be used for adults who cannot comfortably lie on their back for a long time, or who might have trouble staying completely still during surgery.

Throughout your surgery, the anesthesia provider will carefully watch how your anesthesia is working, and make adjustments if needed. They will also continually check your "vital signs" including breathing, blood pressure, and heart rate.

What will happen after my surgery? — Your anesthesia provider will check on you as you recover from surgery. How you feel will depend on what type of anesthesia you had:

●If you had local or regional anesthesia, your eye will probably continue to feel numb for a little while. If you had a sedative, you will probably feel sleepy until the effects wear off.

●If you had general anesthesia, you will likely be groggy and maybe a little confused for a short time after waking up. If you had a breathing tube, your throat might be a little sore for about a day. You might also have nausea or vomiting. If so, you will get medicines to treat this.

Your surgeon will explain that you might have some eye pain during the first day or so after surgery once any numbing medicine wears off. They might give you pain-relieving medicines such as acetaminophen (sample brand name: Tylenol) to help with this. Depending on what kind of anesthesia you had, you might need to wear an eye patch for a day or so. You might also get prescription eye drops to help your eye heal.

Your doctor will give you instructions about returning to normal activities. They might tell you to avoid or limit activities that involve your eye, like reading, watching TV, or driving.

You will get a phone number to call if you have certain problems after going home. Your surgeon will talk to you about when to come back for a follow-up appointment.

More on this topic

Patient education: Anesthesia (The Basics)
Patient education: Cataracts (The Basics)
Patient education: Open-angle glaucoma (The Basics)
Patient education: Angle-closure glaucoma (The Basics)
Patient education: Detached retina (The Basics)
Patient education: Questions to ask if you are having surgery or a procedure (The Basics)
Patient education: Fasting before surgery (The Basics)
Patient education: Managing pain after surgery (The Basics)