This document is a brief summary only.  On the day of your surgery your anaesthetist will answer all of your questions and together you will decide on the best anaesthetic technique for you.

“Topical” anaesthesia

Selected patients

“Topical” anaesthesia has been suggested as a suitable anaesthetic technique for you.  It is not suitable for other patients such as those who are very anxious, have breathing difficulties, can’t communicate easily or have potentially difficult surgery.

Definition: Topical anaesthesia means using local anaesthesia eye drops to numb the surface of your eye. The eye can still move, but will be numb.


“Topical” anaesthesia has several advantages – you will be able to see from the eye immediately following the surgery, which reduces the risk of a fall compared with having a pad over the eye.  There will be a transparent shield over the eye for protection.  It is uncommon* to get complications such as bruising around the eye.

Topical anaesthesia avoids the rare* risks of local anaesthetic injections.

Anaesthesia technique

  • IV insertion: You will have a small plastic tube, an intravenous cannula, inserted into a vein in your arm so that medications can be quickly given if needed.
  • Sedation: You may receive a sedative medication which will help you feel calm and relax, help you to stay still, make the time pass quickly and limit any memory of what follows. You will be awake but breathing for yourself, and should feel calm.
  • Topical anaesthesia: You will be given anaesthetic drops on to the surface of the eye and the surgeon will use additional local anaesthetic inside your eye. This may sting a little before we clean the eye with disinfectant solution.
  • Positioning and procedure: You may have tape across your forehead to reduce the risk of head movement. Your other eye will be taped shut for protection. You will feel the surgeon touching you and you may hear the staff talking and see light and shapes. You should never feel any pain. If you have pain during the procedure, please say “stop” to allow the team to fix this for you. During the procedure, please try to stay still, avoid talking and look straight ahead at the bright light. The team will all be there to support you with any concerns.

What are the anaesthetic risks?

  • Bruising where the intravenous cannula was inserted is common* This will usually resolve in a few days.
  • Mild pain or discomfort during the surgery is common* but it is usually minor and transitory and needs no treatment.

If the pain is persistent and significant to you then you must tell the surgeon and the pain will be treated with additional local anaesthesia or sedation.

  • Incomplete anaesthesia contributing to surgical complications is uncommon*.
  • Problems with your heart, blood pressure or breathing resulting in a longer stay in hospital are uncommon*.
  • Post-operative pain is more common than with other local anaesthetic techniques and is usually relieved by simple pain-killers such as paracetamol.

* Definitions used

  • Very common (1 in 10) such as getting the flu or food poisoning this year.
  • Common (1 in 100) such as winning any prize in one game of Saturday Lotto.
  • Uncommon (1 in 1000) such as winning the trifecta in a 13-horse race.
  • Rare (1 in 10,000) such as being struck by lightning.
  • Very rare (1 in 100,000) such as dying from a snake, bee or other venomous bite or sting.

Do you want more information before the day of surgery?

If you wish to discuss in more detail the risks, proposed technique or possible complications of your anaesthetic, please ring the Pre-admission Clinic on 03 9929 8647 (Monday to Friday between 9am and 4pm) and arrange an appointment with a specialist anaesthetist.

Disclaimer This document describes the generally accepted practice at the time of publication only. It is only a summary of clinical knowledge regarding this area. The Royal Victorian Eye and Ear Hospital makes no warranty, express or implied, that the information contained in this document is comprehensive. They accept no responsibility for any consequence arising from inappropriate application of this information.

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  • Anaesthetic Techniques and Risks – Topical Cataract #176
  • Owner: Department of Anaesthetics
  • Last Reviewed: June 28, 2023
  • Next Review: June 28, 2028