Do You Have To Be Awake For Eye Surgery

Do You Have To Be Awake For Eye Surgery?

Having eye surgery can be intimidating. Many patients will ask their eye surgeon, “Do you have to be awake for eye surgery.” 

Let’s take a look at the different cases of eye surgeries and which ones you are generally awake for.

Do You Have To Be Awake For Eye Surgery: Type Of Surgery

For the most part, yes, you will be awake. However, it does ultimately depend on the type of surgery. Let’s take a look.

Cataract Surgery Or Vision Correction Surgery

If it is cataract surgery or vision correction surgery, patients are usually awake. Surgeries in these two categories tend to be pretty fast. Cataract surgery can usually be completed in 10 to 30 minutes.Vision correction surgeries like LASIK or PRK also are very quick. They take any where between 10 and 20 minutes per eye. 

Eyelid Surgery

For eyelid surgery, such as an eyelid lift (blepharoplasty), patients are generally awake for this as well. Sometimes these can be done in the office, or they are done in a surgery center.

Orbital Surgery Or Strabismus Surgery

For certain types of surgery like orbital surgery or strabismus surgery, the patient is typically put to sleep. These surgeries tend to be longer than the previous two types of surgeries. Additionally, these surgeries require a lot more manipulation of the eye and this can be uncomfortable for the patient. If the patient is moving around too much this can also pose a technical challenge to the surgeon. 

Are Children Awake For Eye Surgery?

Another very common question that parents have. In almost all cases, children are not awake for eye surgery. Because they are unlikely to stay still, it is in their best interest to have general anesthesia for surgical procedures in general, and specifically on their eye. 

Eye surgery requires a very detailed amount of precision. It is very difficult for an ophthalmologist to operate on an eye that is not absolutely still. In addition to being unpredictable in their movements, children are also very scared to be in an operating room with several doctors and staff that they don’t recognize. Usually a parent will accompany the child into the operating room. Once the child is put to sleep, the parent leaves. This way the child has a parent with them until they get the anesthetic medication. 

What Are The Advantages To Being Awake During Eye Surgery?

Although it may not seem great for a patient to be awake during surgery, there are a few advantages. One of these is that the patient does not have to undergo general anesthesia. The anesthesia that is given to the patient is local anesthesia to help for pain control at the site of the surgery. General anesthesia is riskier than local anesthesia and also takes longer to recover from.

Another advantage is that for a compliant patient, the surgeon may ask them to adjust their position to make the surgery technically easier. 

What Are The Downsides To Being Awake During Eye Surgery?

For some patients being awake could be a problem during eye surgery. Let’s take a look at the downsides of being awake during eye surgery.

Anxious Patients

For patients who have anxiety or get nervous during medical procedures, it may be hard for them to remain calm during eye surgery. The eye is a very small and sensitive field. This means that there is very little room for error. If a patient is moving around a lot during the surgery because they are nervous, this can make it very challenging for the eye surgeon.

If you think you are going to not be able to stay still, you should let your doctor know so that they can think about general anesthesia. Again, it is important to remember that the vast majority of eye surgery is not done with general anesthesia, so this could require extra set up time and finding a facility that has the capability to do this. 

Patients With Movement Disorders

If you have a movement disorder, such as Parkinson’s, it will generally be recommended that you have general anesthesia for your eye surgery. This is not always the case and will depend on the severity of disease as well as the presence of other medical conditions. Also, the type of surgery being done will factor into this decision as well. If the surgeon can not effectively control your eye, then it may be for the best to have general anesthesia. 

Do You Have To Be Awake For Eye Surgery: Summary

In general, most patients are awake for the vast majority of eye surgeries. The most common eye surgeries that patients are almost always awake for are cataract surgery, and laser vision correction surgery. Laser vision correction includes surgeries like LASIK, PRK and SMILE eye surgery. 

Children are typically not awake for eye surgery. Unless it is a very minor procedure inside an office, it is safest to bring the child to the operating room so that the eye surgeon has full control over the operative field. 

If you are very anxious and do not think you can stay still, it is important to talk to your doctor about this. An eye surgeon needs a calm and stable field in order to perform at their best. Operating on a moving target is very difficult and can result in poor outcomes. 

If you have a movement disorder that is out of your control, this may also be a reason to have general anesthesia and be put to sleep for the eye surgery. Remember that overall general anesthesia carries more risk than local anesthesia but in some cases it may be necessary.

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