February 28, 2022 | Lasik

Are You Awake During Lasik?

By Barrett Eubanks, M.D.

Are You Awake During Lasik?

Through the near magical power of lasers, lasik is capable of reshaping the cornea and correcting vision. But this sounds real painful. Or if not painful, this sounds like it can be screwed up very easily if you blink or look the wrong way. Can it really be that you are awake the whole time during this procedure?

When you have lasik done, you are entirely awake during the procedure. But this isn't anything to fear, lasik is a very quick and easy procedure to go through. While you do have some strange sensations, numbing eye drops take care of pain. And frequently, you are given medication for anxiety beforehand.

But of course, it still is stressful to know that you are going to be awake. It's healthy and normal to have some anxiety when anything is being done to your eyes. To help with this stress, it's good to know exactly what you will experience during lasik.

Being Awake Is Important to Follow Simple Commands

During lasik, there are certain parts that require you to follow very simple commands. But don't worry, the success of lasik doesn't rely on you following these commands super well.

The laser used to do a lasik treatment has built-in eye tracking. Before doing the treatment, the laser detects your pupil to adjust for any small eye movements; everyone WILL have some small eye movements.

But for this to work, you need to be looking in the general direction of the laser. The laser is only capable of adjusting to small eye movements to certain extent. If you are completely looking away from the laser, it will no longer be able to adjust to provide a perfect treatment. So the laser pauses the treatment if you look away. Thus, even if you look away, you can't screw up the treatment.

So why do you need to be awake for this? If you were sleeping, there is a good chance that you won't be looking in the proper direction for the treatment and the laser won't treat. But when you are awake, you can control where you look and the laser can treat.

Numbing Eye Drops Work Very Well

The second main reason why you aren't put asleep during lasik is that there is no need to.

For big surgeries, you are put to sleep because otherwise the surgery would be extremely painful. But being put to sleep isn't risk free. If that can be avoided during surgery, it makes the surgery even safer.

With smaller surgeries and procedures, sometimes numbing medication can be injected to make everything pain free. If you've ever gotten stitches placed, you know that they inject medication such as lidocaine around the cut before placing the stitches. You don't need to be put asleep for this small surgery.

With the eye, it just happens that we use eye drops for this purpose (no injections). And the cornea absorbs these eye drops and becomes completely numb. These eye drops work very well! You just simply won't have eye pain from lasik. And they last the entire short duration of the lasik procedure.

Numbing Eye Drops Can't Erase All Sensations

While these eye drops work perfectly for eye pain, there ARE a few other sensations in which you will still feel and notice.

Before lasik is started, a special instrument is placed in between the eyelids to prevent any blinking. For some people, this eyelid holder can be uncomfortable or cause some pain. As it expands to keep the eyelids off the cornea, it can cause a stretching sensation on the eyelids. This eyelid holder may at time press up against a bone and cause some bone pain. And finally, if you are squeezing down on this eyelid holder, again you can generate some pain in the eyelids. When the eyelid holder is in place, it's best to practice normal blinking like nothing is even there; but easier said than done.

These eyelids aren't numb like the actual eye. Thus, you can at times also feel things brushing up against the eyelids. This can cause a tickling sensation.

You will experience a pressure sensation during lasik. Numbing eye drops don't affect the pressure sensors in our eye. This pressure sensation will occur during the first step when a laser is used to create the lasik flap. Again, we want to make sure that eye movements have no effect on the treatment. To ensure the treatment goes perfectly, this laser will actually suction onto the eye and prevent any eye movements at all. This suction will generate a large amount of pressure on the eye that you will feel.

Lastly, during the procedure, you can notice a cool sensation from the water used to wash and clean the surface of the eye or stretching sensation from small instruments used to lift up the lasik flap.

All of these extra sensations you feel during lasik aren't pain. But if you aren't expecting these, this can cause extra anxiety. And if you focus hard on these sensations, you can convince yourself that you are in fact feeling pain. So to make things even easier, very often medication is used to help.

Medication To Make Lasik Easier While Awake

To help get you through lasik, many surgeons will give you medication to reduce stress and anxiety. The less stress you have during lasik, the easier it is to go through the procedure. Being anxious can cause you to squeeze on the eyelid holder and cause discomfort. Being anxious can cause you to focus more on the extra weird sensations and cause you more stress.

But if you are stressed, you aren't alone. Everyone will have stress before lasik.

Thus, it is very routine to be given or offered a xanax or valium prior to the procedure. This helps to calm you your levels of stress and anxiety. Being calmer just makes lasik a more pleasant experience.

However, it still is good to know that xanax or valium won't work miracles. You can sometimes still have stress or anxiety even despite taking these medications. It will just simply take the edge off.


You are awake during lasik. But it's not without reason. Being put asleep is unnecessary for lasik. The eye drops used during lasik make the surgery pain free. And very frequently medication is given beforehand to make your experience even easier.

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