Assessment of Subjective Visual Experiences During Intraocular Surgery and Intravitreal Injection Among Uveitis...

Patients frequently report visual sensations during ophthalmic surgery; however, data in uveitic eyes remain limited. Patients with Uveitis  represent a unique population group because of the chronic inflammatory course, systemic associations, and prolonged pharmacologic exposure, which may influence intraoperative perception and anxiety. This study aimed to characterize the nature and impact of intraoperative subjective visual experiences in patients with uveitis undergoing intraocular surgery or intravitreal injection and to evaluate the association of these experiences with uveitic activity, preoperative anxiety, and intraoperative physiological fluctuations.

This prospective cross-sectional observational study was conducted at a tertiary eye care hospital between June 2022 and July 2023. Seventy-six patients with uveitis undergoing anterior segment surgery, posterior segment surgery, or intravitreal injection were enrolled. Patients younger than 18 years, those requiring general anaesthesia, or with psychiatric/systemic disorders affecting perception were excluded. Demographic variables, uveitis type, systemic history, and visual acuity were recorded. Preoperative anxiety was assessed using the Amsterdam Preoperative Anxiety and Information Scale (APAIS). Intraoperative visual phenomena were evaluated postoperatively using a standardized questionnaire, while vital parameters (blood pressure, pulse rate, and SpO₂) were monitored throughout surgery.

Among 76 patients (mean age 56 years; 48.7% male, 51.3% female), 60.5% underwent anterior segment surgery, 17.1% posterior segment surgery, and 22.3% intravitreal injections. All retained light perception intraoperatively. Common experiences included seeing colours (76.1% anterior; 61.5% posterior; 41.2% intravitreal), floaters (63%, 23%, 64.7%, respectively), and flashes (43.4%, 61.5%, 23.5%). Frightening perceptions occurred in 26.3% overall, significantly more in male patients (P = 0.008) and those with better preoperative visual acuity (P = 0.014). Notable intraoperative fluctuations were observed in systolic/diastolic blood pressure and pulse rate.

Patients with uveitis consistently experience intraoperative visual sensations irrespective of disease activity or surgical type. The occurrence of fear underscores the need for structured preoperative counselling, tailored anaesthetic management, and vigilant systemic monitoring to enhance patient comfort and surgical safety.

CTRI/2022/07/043763.