Do I get knocked out for a cataract surgery procedure?
Cataract surgery is one of the most commonly performed medical procedures worldwide, known for its high success rate and life-changing results. If you’re preparing for cataract surgery to correct your vision problems, you might find yourself getting squeamish about the idea of surgery on a delicate and sensitive organ like your eye – and that’s absolutely natural!
So, are you put under anaesthesia during cataract surgery? Or are you awake? We’re here to provide you with the answers to all your burning questions about the procedure, as knowing what to expect during the surgery can help ease any concerns you might have. For those seeking cataract surgery in Cheshire, you can book a free video appointment with Mr Dan Nguyen or take a suitability self-test today to learn more.
This article explores why most people remain awake during cataract surgery, the options for sedation, and how numbing is applied to ensure a pain-free experience, even if you’re not knocked out. By the end, you’ll have a clear understanding of what happens during the procedure and why it’s designed to prioritise your safety and comfort.
What happens during cataract surgery?
Cataract surgery is a straightforward outpatient procedure that replaces the cloudy lens in your eye with a clear artificial one. It’s designed to restore your vision and improve your quality of life. Here’s a step-by-step overview of what you might expect:
1. Pre-operative preparation
When you arrive at the clinic, a team member will welcome you and ensure you are comfortable. The pre-operative preparation involves confirming your medical history, checking your vital signs, and ensuring you are ready for the procedure. Your ophthalmologist will discuss the surgery with you, address any last-minute questions, and reassure you about the process.
You may also receive a mild sedative to help you feel relaxed if you are anxious.
2. Anaesthesia and numbing
Before the procedure begins, the anaesthesia team will administer local anaesthesia to ensure you do not feel pain. This is usually done using numbing eye drops applied directly to the surface of your eye.
3. The surgery
During cataract surgery, your ophthalmologist will carefully make a tiny incision in the surface of your eye using a specialised microscope. Through this incision, the cloudy lens is removed using a process called phacoemulsification, which involves breaking the lens into small pieces with ultrasound and gently suctioning them out. Once the cloudy lens is removed, a new clear artificial lens is inserted into the same position. The procedure typically lasts 10 to 20 minutes, during which you will not feel pain but may see bright lights or blurry shapes.
4. Recovery and discharge
After the procedure, you will be taken to a recovery area where you can rest for a short time. The medical team will monitor you to ensure there are no immediate complications, either from the surgery or the possible sedation. Before discharge, they will provide you with instructions for post-operative care, including the use of protective eyewear and prescribed eye drops.
Most patients can leave the clinic the same day and return home with minimal discomfort. It is normal to feel some mild irritation or sensitivity, which usually resolves within a day or two.
Are you knocked out for cataract surgery?
The short answer is no—you are not typically put under general anaesthesia (i.e. “knocked out”) for cataract surgery. Instead, the procedure is performed while you’re awake, using local anaesthesia to numb the eye.
What does “being awake” mean in cataract surgery?
Being awake doesn’t mean you’ll feel or see everything happening. Thanks to the numbing medication, you won’t experience any pain. Your vision during the procedure will likely be blurry, and you may only notice bright lights or vague movements. Rest assured, the surgical team will keep you comfortable and guide you through the process.
What are the options for sedation during cataract surgery?
While most people remain awake, mild sedation can be an option for those who feel anxious or uncomfortable. Sedation helps you relax without putting you completely to sleep.
Types of sedation
Oral sedation
Oral sedation involves taking a prescribed pill before the cataract surgery. This option is ideal for patients who feel anxious about the procedure but prefer a minimally invasive method to calm their nerves. The medication works by gently relaxing your body and mind, helping you feel more at ease while remaining awake and aware.
Since oral sedation takes time to take effect, it’s typically administered about an hour before the procedure. While under oral sedation, you can still respond to instructions from the surgical team, ensuring the procedure runs smoothly and efficiently.
It’s important to arrange for someone to drive you home afterwards, as the sedative may cause drowsiness for a few hours.
Is full sedation ever used for cataract surgery?
In rare cases, general anaesthesia may be used, such as:
- For patients with severe anxiety who cannot remain calm.
- When other medical conditions make it difficult to stay still.
- In complex surgical cases where more time is required.
Your ophthalmologist will assess your needs and discuss the best approach to ensure your safety and comfort.
What numbing is used for cataract surgery?
Local anaesthesia is the standard method used to numb the eye during cataract surgery. This makes sure you don’t experience any pain while keeping the procedure safe and efficient.
Types of local anaesthesia
Eye drops (topical anaesthesia)
Topical anaesthesia is administered directly to the surface of the eye in the form of eye drops. This method ensures the eye is fully numb, allowing you to remain awake and comfortable during the procedure.
One of the main advantages of topical anaesthesia is its simplicity. The drops act quickly, eliminating pain without the need for injections. Patients often report feeling at ease with this approach, as it avoids invasive techniques and keeps the process straightforward. Topical anaesthesia has become the most commonly used method for cataract surgery due to its effectiveness and convenience. It also allows for faster preparation and recovery times, making it an ideal choice for many.
Injection (regional anaesthesia)
For some patients, regional anaesthesia may be preferred or necessary. This method involves an injection near the eye, which numbs deeper areas to ensure total comfort during the procedure. Regional anaesthesia is particularly useful in cases where additional numbing is required, such as for patients who may have a heightened sensitivity or for more complex surgeries.
While the idea of an injection might seem daunting, the process is carried out with the utmost care, often after applying a numbing gel to minimise discomfort. Patients who receive regional anaesthesia can rest assured that they will not feel pain and that the surgical team will closely monitor their comfort throughout the procedure.
Does the numbing process hurt?
The numbing process is virtually painless. When eye drops are applied, you may feel a cool sensation. If an injection is needed, a tiny needle is used, and you won’t feel much thanks to a pre-applied numbing gel.
How long does the numbing last?
Numbing agents typically last for the duration of the surgery and slightly beyond. You won’t feel any pain during the procedure, and any discomfort afterwards is minimal.
Why are most people left awake during cataract surgery?
Keeping patients awake during cataract surgery is a standard practice for several reasons:
1. Safety
Local anaesthesia avoids the risks associated with general anaesthesia, such as breathing complications. General anaesthesia can have side effects, especially in older adults, including nausea, prolonged recovery times, and in rare cases, respiratory issues.
By using local anaesthesia instead, these risks are significantly minimised, ensuring a safer procedure for most patients.
2. Efficiency
Cataract surgery is a quick procedure, typically lasting 10–20 minutes. Full sedation or general anaesthesia would require additional preparation and recovery time, prolonging the process unnecessarily. By keeping patients awake, the entire experience is streamlined, allowing you to go home shortly after the procedure.
3. Patient cooperation
Your surgeon may need you to follow simple instructions during the surgery, such as looking in a specific direction or keeping your head steady. This level of cooperation ensures that the artificial lens is positioned accurately and that the procedure goes smoothly. Being awake allows for this vital interaction, which contributes to the surgery’s high success rate.
What if i’m too nervous to stay awake?
If the idea of staying awake makes you anxious, share your concerns with your care team. They can offer sedation or other support to help you feel at ease. Remember, it’s normal to feel a bit nervous, and the team is there to ensure your comfort every step of the way.
Common questions about anaesthesia and cataract surgery
What happens if i blink during surgery?
Don’t worry about blinking—a special device gently holds your eye open to ensure it stays steady during the procedure.
Will i feel any pain during cataract surgery?
No, the numbing medication ensures you won’t feel pain. Some patients report mild pressure or a sensation of movement, but nothing uncomfortable.
Can i choose general anaesthesia if i want?
General anaesthesia is not typically offered unless there are specific medical reasons. However, you can discuss your concerns with your surgeon to explore all available options.
What to expect after cataract surgery
Recovery from cataract surgery is usually smooth and quick, and since you’ll most likely be awake, you’ll be able to leave the clinic and return home soon after the procedure.
As the anaesthesia wears off
As the anaesthesia begins to wear off, you might notice mild scratchiness or a gritty sensation in the operated eye. This is entirely normal and usually subsides within a day or two. Some patients describe a slight feeling of dryness or sensitivity to light, which can be managed with lubricating eye drops as prescribed by your doctor. Your vision may initially appear blurry or cloudy, but this typically improves within hours as your eye starts to heal.
Post-operative care
Your surgeon will provide detailed instructions to ensure a smooth recovery. This often includes:
- Using prescribed eye drops to prevent infection and reduce inflammation
- Avoiding strenuous activities, including heavy lifting or bending over, for at least a week
- Refraining from rubbing or touching your eye, as this could interfere with the healing process
- Wearing a protective eye shield, especially while sleeping, to prevent accidental contact.
Follow-up appointments will be scheduled to monitor your healing progress. It’s essential to attend these appointments to ensure your recovery is on track.
Vision improvements
Most patients notice a significant improvement in their vision within the first few days following surgery. Colours may appear brighter, and your overall vision clarity will begin to enhance. While some improvement is immediate, your vision will continue to stabilise over the next 4–6 weeks. For many, this marks a life-changing transformation, allowing them to enjoy daily activities with greater ease and independence. However, some patients may still need glasses for specific tasks, such as reading or driving, depending on the type of intraocular lens (IOL) used.
Final thoughts
Cataract surgery is a safe and effective procedure designed to improve your vision and quality of life. While most patients remain awake with local anaesthesia, options like sedation are available to address individual needs and concerns. Discuss your preferences with your ophthalmologist to ensure the best experience possible.
Cataract surgery with Dan Nguyen
Choosing to have your cataract surgery with us means opting for a personalised, expert approach to your eye care needs. By visiting us, you can bypass the waiting lists and access state-of-the-art treatments designed for your lifestyle and vision goals.
Don’t let long wait times or changing vision stand in your way. Be proactive about your eye health and book a free video appointment with us today or take our suitability self-test. We’re ready to ensure your journey to clear vision is smooth and successful!
DISCLAIMER: The information provided in this article is intended for general informational purposes only and should not be construed as medical advice, diagnosis, or treatment. The products and methods mentioned are not a substitute for professional medical advice from a trained healthcare specialist. Always seek the guidance of your doctor or other qualified health professional with any questions you may have regarding your health or a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. Use of the information and products discussed is at your own risk.
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Mr Dan Nguyen
MBChB MBA FRCOphth FRANZCO
Consultant Eye Surgeon
Hello, I’m Dan Nguyen!
I‘m your guide to better vision. In times when long waiting lists and unclear options are the norm, it’s easy to feel stuck and worried about your eye health. Don’t let that hold you back. I’m here to show you that you can skip the endless queues and make real progress. Remember, you’re unique, not just another name on a list. Every patient I see receives top-notch care, tailored to their specific needs and lifestyle. Once you’ve had your treatment, you’ll be able to embrace a life that’s vivid, colourful, and just the way you like it. So what are you waiting for? Stop waiting and start living!
