The blue and green surgical attire worn by doctors in the operating room is one of the most recognizable uniforms in medicine. This color choice is a deliberate decision rooted in the science of human vision and the practical demands of a surgical environment. The colors are specifically selected to reduce eye strain, minimize visual distractions, and improve the surgeon’s ability to perceive fine anatomical details during lengthy procedures.
The Shift from White Attire
For many years, the standard dress for surgeons and other medical staff was white, a color meant to symbolize cleanliness and purity in a sterile setting. This tradition, however, presented significant problems once the operating room environment grew more technologically advanced. As powerful overhead lights were introduced to illuminate the surgical field, the bright white fabric of the scrubs became a source of intense, distracting glare.
The combination of bright white material and focused lighting caused considerable eye strain and headaches for the surgical team during long operations. The stark, dazzling white reflected too much light, forcing the eye to constantly adjust between the bright uniform and the darker surgical area. This led to a consensus among medical professionals that a non-reflective, darker color was necessary to create a more comfortable visual environment. The shift to blue or green attire began in the early 20th century, with one influential doctor reportedly making the change around 1914.
Visual Science and Reducing Eye Strain
The primary reason blue and green were chosen relates directly to color science and the physiological response of the eye’s photoreceptor cells. During a procedure, a surgeon’s gaze is fixed almost entirely on the patient’s internal anatomy, which is dominated by various shades of red blood and tissue. Staring intensely at any single color for an extended period causes the cone cells in the retina, which are responsible for color vision, to become temporarily fatigued or desensitized.
When the surgeon momentarily shifts their focus from the red surgical field to a white or light-colored object, they experience a visual phenomenon called a negative afterimage. This afterimage appears as a momentary “ghost” of the original image in the complementary color. Since red fatigues the visual system, the afterimage that appears on a white surface is a distracting spot of cyan or blue-green. Blue and green are directly opposite red on the color wheel, making them the complementary colors to red. By positioning a complementary color in the peripheral vision, such as the blue or green scrubs of a colleague, the surgeon’s eyes are continuously exposed to a hue that helps neutralize the visual saturation caused by the red. This action effectively “resets” the eye’s sensitivity, preventing the fatiguing afterimage effect. This helps maintain the surgeon’s visual acuity and sensitivity to the subtle variations in red necessary to distinguish between healthy and diseased tissue.
Practical Benefits of Color Contrast
Beyond the physiological benefits of reducing eye strain, blue and green offer distinct practical advantages related to contrast and distraction management. The contrast between the cool tones of the scrubs and the warm, reddish-pink tones of the surgical site makes the patient’s anatomy stand out more clearly, allowing surgeons to better perceive the boundaries between different tissue types and organs.
The color choice also manages the visual impact of accidental blood or fluid splatter, which is inevitable in surgery. On a white uniform, blood stains appear stark, bright red, and highly distracting to the eye. Conversely, when blood is seen against a blue or green background, the complementary colors make the stain appear darker, often a dull brown or black. This minimized visual jarring helps the surgical team maintain focus on the procedure.