Medically reviewed by Dr. Niranjana Bejan Singh. Written to established clinical-education standards (AAO/Mayo/NHS/NEI) and adapted for this hospital. Not a substitute for professional medical advice.
Peribulbar and retrobulbar blocks are types of local (regional) anesthesia used to numb the eye and surrounding area for certain eye surgeries, most often cataract surgery, but also some retinal, glaucoma, or oculoplastic procedures. A fine needle delivers anesthetic near the eyeball (peribulbar) or behind it (retrobulbar), numbing the eye and temporarily limiting eye movement so surgery can be performed without pain and with the eye held still.
Who typically needs this
- Patients undergoing cataract surgery, certain retinal or vitreoretinal procedures, glaucoma surgery, or oculoplastic surgery where a still, pain-free eye is needed.
- Often chosen for longer or more complex procedures where surface (topical) anesthesia alone would not provide enough comfort or eye stability.
- Suitable for most adults; the surgical and anesthesia team assesses individual suitability based on eye anatomy, medical history, and the specific procedure planned.
- Patients on blood thinners or with certain eye or orbital conditions may need special evaluation, adjusted timing of medication, or an alternative technique.
What to expect
- The skin around the eye is cleaned, and light sedation may be given to help the patient relax.
- A fine needle delivers local anesthetic either around the eye socket (peribulbar) or behind the eyeball (retrobulbar), guided by the clinician's knowledge of eye and orbital anatomy.
- The injection is often followed by gentle pressure on the eye to help the anesthetic spread evenly.
- Onset of numbness and reduced eye movement is checked before surgery begins, typically within a few minutes.
Recovery
- Numbness and any double vision from the block typically wear off within a few hours after surgery.
- Patients are advised not to rub the eye and to follow the surgeon's standard post-operative care instructions.
- Mild bruising or swelling around the injection site can occur and usually resolves on its own within days.
- Vision in the treated eye will be blurred immediately afterward due to both the anesthesia and the surgery itself, improving as recovery progresses.
Risks to know about
- As with any injection near the eye, there is a small risk of bleeding, bruising, or infection at the injection site.
- Rare but recognized risks include inadvertent injury to the eyeball, optic nerve, or nearby blood vessels, and, very rarely, spread of anesthetic affecting other nerves.
- Temporary double vision or a drooping eyelid can occur after the block and typically resolves within hours to days.
- The surgical team selects and performs the block carefully to minimize these risks and will discuss them with you before your procedure.
Frequently asked questions
Will I be awake during the surgery?
Yes, typically. These blocks numb the eye while you remain awake, often with light sedation to help you relax; you should not feel pain.
Is the injection painful?
There can be brief discomfort during the injection itself, often reduced with sedation or numbing drops applied beforehand; the eye area is numb within minutes afterward.
How long will my eye stay numb afterward?
Numbness and any reduced eye movement usually wear off within a few hours after the procedure.
What is the difference between a peribulbar and a retrobulbar block?
Both numb the eye for surgery; a retrobulbar block places anesthetic further behind the eyeball, while a peribulbar block places it around the eye socket. The team chooses based on the procedure and individual factors.
Ready to see us?
Call the appointment desk, or book online — we will confirm your time by phone.
Sources consulted: NHS — Local Anaesthesia, Mayo Clinic — Cataract Surgery . General medical information — not a substitute for professional diagnosis. Medically reviewed by Dr. Niranjana Bejan Singh.
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