Anaesthesia in ophthalmology has been a popular topic of discussion since the beginnings of the profession. General anaesthesia or sedation paved the way for early ocular surgery until the discovery of cocaine and the development of the hypodermic needle allowed topical and local anaesthetics to gain momentum in the mid-1800s. Almost a century later, improved anaesthetic agents and the addition of epinephrine and hyaluronidase have led to significant improvements in anaesthetic safety and efficacy.

Since then, much of the discussion has focused on the particular route of administration. Variations of facial neve, retrobulbar, peribulbar and sub-Tenon anaesthesia cycled in popularity over the next 50 years. Finally, topical anaesthesia was revived in the 1990s and …