Laser eye surgery, such as LASIK or PRK, corrects vision by reshaping the cornea, the clear front surface of the eye. The short answer is no, you cannot be fully sedated. General anesthesia, which would put you completely to sleep, is not used. Instead, a combination of local anesthesia and mild relaxation medication is standard practice. The patient must remain awake and cooperative for the brief duration of the procedure to ensure the surgeon achieves the highest level of precision and a successful outcome.
Standard Comfort Measures
To manage anxiety or discomfort, the surgical team employs specific measures designed to keep the patient calm without inducing unconsciousness. The primary tool for pain management is the application of topical anesthetic drops directly into the eye. These numbing drops completely block pain sensations in the eye, making the procedure painless.
These drops are administered just before the procedure begins and last long enough to cover the entire short treatment time. Additionally, it is common practice to offer an oral anti-anxiety medication, like a mild sedative, about 20 to 30 minutes before the surgery. This medication helps the patient feel more relaxed and calm.
A typical oral dose is carefully managed to reduce nervousness without causing the patient to become overly drowsy or confused. This mild sedation allows the patient to remain fully alert and able to follow instructions from the surgeon. Patients who take this medication are required to have someone drive them home after the procedure, as the relaxing effect can last for several hours.
Why Deep Sedation is Not Used
Deep sedation, or general anesthesia, is actively avoided because patient cooperation is required for the surgery’s success and safety. The laser needs to be precisely aligned to reshape the cornea according to a specific, customized map of the eye. The surgeon requires the patient to consciously focus on a target light for a short period, which helps fix the eye in the correct position for the laser application.
Anesthetizing a patient completely introduces the risks associated with general anesthesia, such as the need for breathing support, which are unnecessary for this quick, external eye procedure. Since laser eye surgery is minimally invasive and does not involve significant pain, the risks of full unconsciousness outweigh any potential benefits. Furthermore, if the patient were asleep, the surgeon would be unable to communicate verbally or monitor the patient’s real-time responses, which is necessary for the procedure’s accuracy.
While movement is a concern, modern excimer lasers are equipped with sophisticated eye-tracking technology that monitors the eye’s position hundreds of times per second. This system can automatically adjust the laser’s aim for minor involuntary movements or shut down instantly if the eye moves too far. However, the patient’s ability to maintain a general focus remains essential to keep the eye within the tracking range and maximize the precision of the laser treatment.
What to Expect While You Are Awake
Since you will be awake and responsive, it is helpful to know the sensory experience. Before the laser is applied, a device called a lid speculum is gently placed to hold the eyelids open, preventing involuntary blinking. The initial sensation a patient feels is often a brief pressure on the eye when the suction ring, which is sometimes used to stabilize the eye, is applied.
Your vision will likely dim or momentarily go dark when this suction occurs, but this is a temporary and normal part of the process. The actual laser application is extremely fast, often lasting only a few seconds to less than a minute per eye, depending on the amount of correction needed. During this time, you may hear a distinct clicking or buzzing sound from the laser machinery.
Some patients also report a mild, unusual odor, which is the smell of molecules being vaporized from the corneal tissue by the non-thermal laser. You will not feel pain due to the numbing drops, but you might be aware of a cool sensation from sterile solutions used on the eye. The entire experience is focused on maintaining a comfortable and communicative environment, with the surgical team typically talking you through each step to manage expectations.