Birmingham and Midland Eye Centre (BMEC)

Operations under local anaesthesia: What to Expect:

Most eye operations at BMEC are performed under local anaesthesia. The eye is gently numbed using an injection in the eye, preventing accidental eye movement, and allowing the surgeon to perform the operation with precision.

While the idea of receiving an injection into the eye may sound daunting, it’s important to note that the pain associated with the injection is comparable to what you might experience at the dentist. Any discomfort during the injection quickly goes within seconds. Some simpler surgical procedures may even utilise local anaesthetic eye drops to numb the surface of the eye.

Under local anaesthesia, you will typically remain awake throughout the operation, but the eye will be numb, ensuring you feel no pain. As the effects of the local anaesthetic gradually wear off, sensation will return over the next few hours. If a sedative is administered by the anaesthetist before the local anaesthetic injection, you may not remember the injection process.

One advantage of local anaesthesia is that you can eat and drink as usual on the day of surgery so you don’t need to fast. Recovery is quicker, with reduced chances of feeling sick or vomiting. Additionally, the pain relief effect of the local anaesthetic persists for a few hours after the operation, allowing you to return to your normal state faster than with general anaesthesia.

On the day of surgery, an anaesthetist will visit you in the ward or day unit. They will assess your condition, address any concerns, explain the anaesthetic technique, and answer your questions. In certain cases, sedation may be offered to enhance your comfort during the procedure, and anaesthetists will oversee its administration.

Operations under general anaesthesia: what to expect:

In certain eye procedures, you may need general anaesthesia, which is a carefully controlled state of unconsciousness. This approach is particularly suitable for various situations, such as complex surgeries, paediatric cases, or instances where patients may struggle to remain still or face communication challenges.

Some patients may also opt for general anaesthesia based on personal preferences. If your upcoming procedure involves general anaesthesia, the confirmation letter detailing your operation date will include specific instructions. Notably, you will be advised to refrain from eating or drinking for six hours prior to the surgery, though water is permissible up until the time of the procedure.

On the day of your operation, your dedicated anaesthetist will visit you to provide a detailed explanation of the anaesthesia process. While most individuals experience a temporary dry throat sensation post-surgery, lasting less than a day, a few may feel nauseous. In such cases, appropriate medications will be administered to alleviate discomfort.

Your anaesthetist will also discuss any relevant risks associated with the anaesthesia tailored to your situation. This is also an opportunity for you to ask any questions or express concerns you may have. It’s important to note that, with advancements in technology and the use of modern anaesthetic agents, serious risks associated with general or local anaesthesia are exceedingly rare for the majority of patients.

Following the procedure even under general anaesthesia, most patients recover swiftly, often allowing them to return home on the same day.

We understand that the prospect of undergoing surgery can be daunting, and we are committed to ensuring your safety and comfort throughout the entire process. If you have any further inquiries or require additional information, please feel free to reach out to our medical team.

The inpatient eye ward at BMEC is based on the first floor of Sheldon Block at City Health Campus.

Contact details: 0121 507 6875 or 6876.

The pre-operative assessment clinic is run at the Birmingham and Midland Eye Centre for patients having surgery.

The clinic is on the second floor of Sheldon Block, ward D46, at City Health Campus.

What happens during your pre-operative assessment?

On the day of your pre-operative assessment, you will see a member of the nursing team.

The nurse will ask you about your health and identify any health issues you may have. You will also be asked about any history of previous operations or anaesthesia you may have had.

The nurse will ask you about your regular medications that you may be  taking. Once the medications have been seen, the nurse will inform you of any pre-op instructions you may to follow prior to your surgery (i.e. stopping certain medications for a period of time.)

During your pre-operative assessment the nurse will check your blood pressure, blood glucose, and may take a MRSA swab to obtain your MRSA status. If having a general anaesthetic, we may need to check your blood levels and perform an ECG.

If you are undergoing cataract surgery, measurements of your eyes will be taken to calculate the size of implant that will be inserted in your eye during surgery. This is called biometry.

Once the pre-operative assessment is completed, you will be given the opportunity to ask any questions you may have regarding your surgery or hospital admission.

Please ensure that on the day of your pre-operative assessment you bring all the medications you are currently taking, as well as any glasses you are currently wearing.

If there are any concerns raised at the Pre Operative appointment, you may be referred for an appointment with an anaesthetist.

Changing your pre-operative assessment appointment:
If you require to cancel or rebook your Pre-Operative Assessment, please contact the Waiting List Office on 0121 507 4440

BMEC offers the following types of laser treatment, mostly on an outpatient basis.

YAG Laser:
YAG lasers are used in ophthalmology to treat posterior capsular opacification, a condition that may occur after cataract surgery, and for peripheral iridotomy in patients with acute angle-closure glaucoma.

Argon laser:
We currently have two Argon laser machines in the outpatient department.

This laser is used to treat:

• Diabetic eye problems at the back of the eye
• Retinal breaks and small localized or chronic retinal detachments
• Retinal vascular problems
• Glaucoma

Occasionally, Argon laser treatment is carried out in the theatre under local or general anaesthesia as a day case procedure.

SLT Laser:
Selective laser trabeculaplasty – this is used to treat raised pressures due to glaucoma.