Patients may see scary lights during eye surgery

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 experiences.

“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 anesthesia.

SOURCE: American Journal of Ophthalmology, December 2005.

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