Subjective visual experience during extracapsular cataract extraction and intraocular lens implantation under retrobulbar anaesthesia

Purpose To investigate the subjective visual experience of patients during cataract surgery under retrobulbar anaesthesia. Methods One hundred cataract patients who underwent routine extracapsular c ataract extraction and intraocular lens implantation under retrobulbar anae sthesia were interviewed by the authors on the same day after their operati on regarding their visual experience in the operated eye during surgery. Results Forty-three men and 57 women were included in the study. Their mean age was 68.4 years (range 40-87 years). Their pre-operative best corrected visual acuity ranged from 6/12 to perception of light. Eighty-four eyes ha d no other ocular pathology apart from cataract. Twenty patients reported n o light perception during the surgery. The rest reported that they could se e light (80 patients), one or more colours (56 patients), movements (39 pat ients), flashes (36 patients), instruments (16 patients) and/or the surgeon 's fingers or hands (10 patients). The colours seen included red (29 patien ts), yellow (29 patients), green (12 patients), blue (11 patients) and oran ge (2 patients). Fifteen patients saw a spectrum of colours similar to that of the rainbow. Forty-four patients reported that the brightness of light changed during the operation. Five patients found their visual experience f rightening. There was no correlation between those who found the experience frightening and the sex or age of patient, presence of coexisting ocular p athology, duration of operation, whether the operation was the first or sec ond cataract operation in the patient, or the type of visual sensation expe rienced. Conclusion Many patients undergoing cataract surgery under retrobulbar anae sthesia experience a variety of visual sensations that may be frightening i n a small proportion of cases.