January 27, 2006

Patients may see scary lights during eye surgery

NEW YORK (Reuters Health) - Patients who are awake while
undergoing surgery on the gel-like vitreous inside the eye
often report seeing frightening lights, similar to what is
experienced by cataract surgery patients, a new study shows. As
a result, many patients say they would opt for general
anesthesia the next time around, despite the greater risk.

About three fourths of patients perceived light during the
surgery, Dr. Colin S. H. Tan of the Eye Institute at Tan Tock
Seng Hospital in Singapore and colleagues report, and a
significant minority reported being frightened by their visual

"A frightening visual experience is clinically significant
because" it may lead to side effects that could complicate the
surgery, such as increased heart rate, high blood pressure, and
fast breathing, Tan and his team note in the American Journal
of Ophthalmology. "A frightening visual experience is also
likely to decrease patients' satisfaction with the surgery."

While most patients perceive light during cataract surgery,
and 3 to 16 percent find their visual experiences frightening,
it is possible that the experience of patients undergoing
vitreous surgery may be different, given that these patients
are likely to have worse vision and the surgery is quite
different, the researchers write.

To investigate, Tan and his team studied 65 patients who
underwent vitreous surgery while awake under regional
anesthesia, a common type of pain control. All were interviewed
about their visual experiences within two hours of the surgery.

Thirty patients reported perceiving light during the entire
operation, 19 reported temporary light perception loss, and 16
did not perceive light at all during the course of the surgery,
the researchers found. Nine of the patients said their visual
experiences were frightening.

Patients who were frightened were younger and had longer
surgeries. All of the patients who reported being frightened
during surgery reported perceiving color, compared to about
half of those who were not frightened.

Nearly 13 percent of patients said they would have
preferred to have general anesthesia to avoid their visual
experiences, and 7.7 percent continued to express this
preference after being told about the risks of general

SOURCE: American Journal of Ophthalmology, December 2005.