Fear of eye surgery: how to manage anxiety before the big day

Being afraid of eye surgery is a normal and very common reaction. Whether you are preparing for laser vision correction or cataract surgery, the apprehension that precedes the procedure deserves to be taken seriously and, above all, demystified. Understanding what awaits you, step by step, is often the best way to turn worry into calm.

UNDERSTANDING

Why fear of eye surgery is normal

The eyes hold a special place in our relationship with the body. As organs of our connection to the world, they combine both a perceived vulnerability and a strong symbolic value. It is therefore not surprising that the prospect of surgery on the eyes generates more anxiety than, for example, an operation on the knee or the hand.

This fear generally takes several forms:

• The fear of not staying still: « What if I move involuntarily? »
• The fear of pain: « Is it going to hurt? »
• The fear of seeing or not seeing during the procedure: « Am I going to see something frightening? »
• The fear of the outcome: « What if something goes wrong? »
• The fear of losing control: staying awake under a surgical microscope is a novel experience for most people.

These questions are legitimate. They deserve precise answers, not vague reassuring phrases. That is precisely the purpose of this article.

ANAESTHESIA

Anaesthesia: what really happens depending on your procedure

The first surprise for many patients: eye operations are carried out under local anaesthesia, without an injection around the eye and without general anaesthesia in the vast majority of cases. The exact protocol nonetheless varies depending on the type of procedure and on where it is performed.

The basic principle is simple: a few drops of a surface anaesthetic (such as oxybuprocaine or tetracaine) numb the cornea and the conjunctiva within a few minutes. But the precise protocol differs depending on your procedure.

Laser refractive surgery: LASIK, PRK, SMILE, PresbyLASIK

At the Clinique Laser Victor Hugo, these procedures are carried out under pure topical anaesthesia: only a few drops of surface anaesthetic eye drops are used, without sedation. You stay perfectly awake, conscious and able to communicate with the team throughout the procedure, which is short.

Cataract surgery and ICL implant

At the Clinique Sainte-Geneviève, the anaesthesia combines eye drops and an anaesthetic gel applied to the surface of the eye, supplemented by light intravenous sedation administered by the anaesthetist present in the operating theatre. You stay conscious and in contact with the team, but this sedation brings additional relaxation to get through the procedure calmly. Supervised by the anaesthetist, it is clearly distinct from an anti-anxiety medication you might take on your own before coming in.

About the eyelid speculum

Many patients dread the idea of not being able to close their eyes. The eyelid speculum is in fact a very fine instrument, often made of soft plastic, that holds the eyelids open without causing pain. You cannot blink, but you feel no pain. The team warns you before it is put in place.

THE PROCESS

The big day, step by step

Knowing the precise course of a procedure is one of the best antidotes to anticipatory anxiety. Here is what happens, from your arrival at the clinic to your departure.

Arrival and welcome

You arrive at the clinic, the Clinique Laser Victor Hugo for refractive surgery (LASIK, PRK, SMILE, ICL), the Clinique Sainte-Geneviève for cataract. The team welcomes you, checks your file, settles you into a quiet waiting area. Surgical attire is provided. This is a moment to ask questions.

Preparing the eye

Eye drops are instilled: first to dilate the pupil if necessary (cataract surgery), then the anaesthetic drops. The ocular surface is cleaned. This phase generally takes 10 to 20 minutes. You remain lying down, and the team communicates with you at every step.

The procedure itself

The actual duration of the surgical procedure is often much shorter than patients imagine:

• LASIK: about 10 to 15 minutes for both eyes, with a few seconds of laser per eye
• PRK / SMILE: similar duration
• Cataract: 15 to 25 minutes per eye, depending on the density of the lens

During the procedure, you are asked to look at a fixation light. You do not have to make any particular effort: eye-tracking systems automatically compensate for the involuntary micro-movements of the eye. You cannot « miss » the laser by moving slightly.

The recovery room and departure

After the procedure, you are settled into a rest area for 20 to 30 minutes. The team checks your comfort, explains the post-operative instructions and the eye drops to instil. You go home accompanied, it is important to arrange for someone to come with you for the return journey.

PREPARATION

Simple techniques to arrive calm on the big day

Pre-operative apprehension is a normal physiological phenomenon. Several simple, non-medicated approaches can significantly reduce it.

1. Get precise information (and stop searching for anxiety-inducing testimonials)

The internet concentrates extreme stories. People whose procedure went well, the vast majority, generally do not post a long testimonial. Those who post are often the ones who had a difficult experience, whether real or amplified by their own anxiety.

The best source of information remains your pre-operative assessment and your consultation with Dr Tourabaly. Ask all your questions, even those that seem naive to you. There is no such thing as a stupid question before an operation.

2. Breathing as a concrete tool

Slow abdominal breathing is the most immediately accessible tool for reducing the anxious response. During the procedure itself, if you feel tension rising, breathe slowly and deeply through the nose, letting your belly rise. This technique:

• Activates the parasympathetic nervous system (the natural brake on anxiety)
• Reduces involuntary muscle tension
• Gives you something concrete to do while the team works

You can practise abdominal breathing in the days before the procedure to make it automatic on the big day.

3. The night before: sleep and practical organisation

A good night’s sleep before the operation is not only a comfort, it plays a role in emotional regulation and stress tolerance. A few practical points:

• Prepare your belongings, your prescriptions and your companion the day before, leave nothing for the morning to avoid logistical stress
• Avoid screens in the two hours before bedtime
• If anxiety keeps you from sleeping, write down the questions that keep circling, they will wait until the next morning
• Follow your practitioner’s instructions regarding make-up, contact lens wear or fasting depending on the type of procedure

4. Arrange for a companion

Coming accompanied on the day of the procedure has several concrete advantages beyond the safety of the return journey: the presence of a loved one reduces the perceived wait, allows the post-operative instructions to be shared (you heard them under stress, it is helpful for a third party to remember them too) and offers emotional support in the immediate post-operative phase.

5. Talk to the team on the morning itself

If you feel particularly anxious on the day of the procedure, say so as soon as you arrive. The surgical team is used to supporting stressed patients. It is not a weakness to say it, it is useful information that lets the team adjust its pace, take a little more time to explain each step and talk to you during the procedure.

CONSULTATION

The role of the pre-operative consultation

The pre-operative assessment is not only a technical examination. It is also the ideal moment to voice your fears, ask your questions and build a relationship of trust with Dr Tourabaly. A practitioner who explains what he is going to do, why and how, directly helps to reduce your level of anxiety on the day of the procedure.

Useful questions to ask during the assessment

• Which technique will be used in my case and why this choice?
• How long does the procedure on the eye actually take?
• What am I going to see and hear during the operation?
• Is there anything I absolutely must avoid doing during the procedure?
• How will I know if something is not going normally?
• What happens if I cannot keep my eye open or stay still?

There is no such thing as a question that is too simple or too naive. Every question asked is an opportunity to clarify a point that, left unanswered, would remain a source of anxiety.

VIGILANCE

When apprehension should lead to postponement

In the vast majority of cases, pre-operative anxiety is not an obstacle to the procedure. It may, however, justify a postponement in certain circumstances:

• Uncontrolled acute stress on the morning itself: intense agitation, involuntary trembling or an inability to cooperate may lead the surgeon to propose rescheduling the procedure for a later date. This is not a failure, it is a considered medical decision.
• Persistent doubts about the decision to operate: if, deep down, you are not convinced that you want to be operated on, the apprehension may be a sign of an ambivalence you have not yet resolved. Take the time for an additional consultation rather than forcing yourself.
• Medical factors linked to anxiety: significantly elevated arterial blood pressure on the big day, linked to stress, may lead the anaesthetist or the surgeon to defer the procedure.

PROCEDURES CONCERNED

What patients experience depending on the type of procedure

The patient’s subjective experience differs slightly depending on the surgery performed. Here are the specifics:

Laser refractive surgery (LASIK, PRK, SMILE)

These procedures are among the fastest. LASIK lasts a few minutes and the patient leaves the clinic with vision often improved as early as the next day. The sound of the laser (a regular clicking) and the characteristic smell (similar to a smell of burnt hair for PRK and LASIK) may surprise those who are not prepared for them. Anticipating them allows you to take them in without an anxious interpretation. To learn more about the refractive surgery journey.

Cataract surgery

Cataract surgery is carried out at the Clinique Sainte-Geneviève under surface anaesthesia (eye drops and gel) supplemented by light intravenous sedation supervised by the anaesthetist. The duration is slightly longer than for laser refractive surgery, but remains short. The patient perceives lights and colours during the procedure, which can be unsettling if you are not expecting it. The team communicates constantly: « we are removing the lens now », « we are placing the implant »… This real-time narration considerably reduces anxiety.

FAQ

Frequently asked questions

Sources and references

1. Wei J, et al. Preoperative Nonpharmacological Anxiety Management in Adult Ophthalmic Surgery: A Scoping Review. J Perianesth Nurs. 2026. PMID 42319315.
2. Kallay O, et al. Hypnosis in photoablative refractive surgery: a monocentric prospective study. J Cataract Refract Surg. 2026. PMID 41739991.
3. Haute Autorité de Santé. Information du patient avant une intervention chirurgicale. Recommandations HAS. Disponible sur : has-sante.fr

Practice in Cachan & Paris 13 • Tel. 01 45 47 00 57

Disclaimer

This article is intended as general information and does not replace a medical consultation. For any question relating to your personal situation, consult an ophthalmologist.