Medically reviewed by Krishna Surapaneni, MD, board-certified ophthalmologist and cataract, cornea, and refractive surgeon at SuraVision in Houston.
Yes, you are awake during cataract surgery. For most people that answer is a surprise, and the next feeling is usually a knot in the stomach. Awake? For eye surgery?
Here is what that actually means. Your eye is completely numbed, you are given medicine to help you relax, the surgery takes about ten minutes per eye, and most patients tell us afterward that the hardest part was the worrying they did beforehand.
This article walks through why you stay awake, what you feel, what you see, and what your options are if the idea still makes you uneasy.
Why you stay awake for cataract surgery
Cataract surgery does not need general anesthesia, the kind that puts you fully to sleep. That is good news, for three reasons.
First, the surgery is short and gentle. The procedure itself usually takes about ten minutes per eye. Putting you fully to sleep for something that quick would add risk without adding comfort.
Second, skipping general anesthesia means skipping its side effects. There is no breathing tube, no grogginess that lasts the rest of the day, and none of the nausea some people get after being put under, as the American Academy of Ophthalmology describes.
Third, recovery starts right away. You are alert within minutes of finishing, you go home the same day, and most patients are back to most normal activities within a day or two.
What kind of anesthesia is used for cataract surgery?
The eye is numbed with local anesthesia, which means only the eye itself is treated while you stay comfortable and aware. There are two common ways to do it: numbing eye drops, called topical anesthesia, or a numbing injection placed around the eye.
At SuraVision, we use the numbing-drop approach. Your eye is numbed with drops, so no needles are involved in numbing your eye. The drops work quickly, and they keep the surface of your eye from feeling pain during the procedure.
On top of the numbing, you are given medicine to help you relax.
Do you need an IV for cataract surgery?
It depends on where your surgery takes place. Some of our patients have surgery in our office surgery suite, and others have surgery at an outside surgery center. Which setting fits you depends on your health and your eyes, and Dr. Sura goes over it with you at your consultation.
If your surgery is in our office surgery suite, we do not routinely start an IV. Your eye is numbed with drops, your relaxation medicine does not require an IV line, and for most office-suite patients that means surgery day involves no needle in your eye and no needle in your arm.
If your surgery is at the surgery center, an IV is routinely placed as part of surgery there, so relaxation medicine can be given through it. Your eye is still numbed with drops the same way, and the surgery itself is the same.
What do you feel during cataract surgery?
With your eye numbed, you should not feel pain. Most patients describe a feeling of light pressure, and some feel nothing at all. There is no cutting sensation and no sharp anything.
The most common thing we hear right after surgery is some version of “Wow, that was it?” The build-up is almost always worse than the experience.
What do you see during cataract surgery?
You will not watch your surgery happening. Your other eye is covered, and the eye being treated sees mostly bright light and soft, shifting colors, similar to looking into a kaleidoscope. You will not see instruments, and you will not see anything approaching your eye.
You also do not need to worry about holding your eye open or keeping it still. A small, gentle device keeps your eyelid comfortably open, and the numbing takes away the urge to blink. If a blink reflex or a cough is on your worry list, we have written about both: what happens if you blink during cataract surgery and what happens if you cough during cataract surgery.
Can you be put to sleep for cataract surgery?
General anesthesia is rarely used for cataract surgery, but it is not banned. It is reserved for situations that truly need it, such as patients who cannot lie still or certain medical conditions. For nearly everyone else, staying awake with a numbed eye and relaxation medicine is the more comfortable and lower-risk path, according to the National Eye Institute.
If you are certain you could never get through eye surgery awake, say so at your consultation. That conversation is exactly what the visit is for, and you deserve a plan you feel calm about, not one you dread.
How long does the relaxed feeling last?
The relaxation medicine is light and short-acting. You will feel calm during the procedure and a little mellow for a few hours after. You will need someone to drive you home, and you should plan to rest for the remainder of the day. Most patients feel like themselves again by the evening. Our article on how long cataract surgery takes walks through the full surgery-day timeline.
If you are nervous, that is normal
Almost everyone is nervous before eye surgery. Telling you the procedure is quick does not always quiet that feeling, so here is what tends to help our patients most: knowing each step before it happens. On surgery day, our team tells you what is coming before it comes, and Dr. Sura talks with you during the procedure so you are never wondering what is happening.
It also helps to remember that cataract surgery is one of the most commonly performed surgeries in medicine, and you can read about how the procedure works step by step ahead of your visit.
Patients come to us from across Houston and the communities south and west of the city, including Sugar Land, Katy, Pearland, and Missouri City. If you are starting your research, our cataract surgery in Houston page covers the whole process from evaluation to recovery.
Call 713-730-2020 to schedule your cataract evaluation, or book online. Not sure whether your cloudy vision is a cataract yet? Our cataract self-test takes about a minute.
Common questions about being awake during cataract surgery
Are you awake during cataract surgery?
Yes. Your eye is numbed with local anesthesia and you are given medicine to help you relax, but you stay awake. General anesthesia is rarely needed because the procedure is short and the numbing keeps you comfortable.
What kind of anesthesia is used for cataract surgery?
Cataract surgery uses local anesthesia, either numbing eye drops or a numbing injection around the eye, along with relaxation medicine. At SuraVision, we use the numbing-drop approach, called topical anesthesia, so no needles are involved in numbing your eye.
Do you need an IV for cataract surgery?
It depends on where your surgery takes place. In our office surgery suite, we do not routinely start an IV. At the outside surgery center, an IV is routinely placed so relaxation medicine can be given through it. Dr. Sura tells you at your consultation which setting fits your health and your eyes.
Can you be put to sleep for cataract surgery?
General anesthesia is rarely used for cataract surgery. It is reserved for situations that truly need it, such as patients who cannot lie still or certain medical conditions. If staying awake worries you, bring it up at your consultation.
Does cataract surgery hurt?
The numbing keeps the surface of your eye from feeling pain during the procedure. Most patients describe a feeling of light pressure at most, and many say the procedure was far easier than they expected.
Do you see what is happening during cataract surgery?
No. You will not watch the surgery or see instruments. The eye being treated sees mostly bright light and soft, shifting colors, similar to a kaleidoscope, and your other eye is covered.
How long are you sedated for cataract surgery?
The relaxation medicine is light and short-acting. You feel calm during the procedure and a little mellow for a few hours afterward, which is why you need someone to drive you home. Most patients feel like themselves by that evening.