When you hear about ICL surgery, also called implantable collamer lens surgery, it can sound a little intimidating. It’s natural to feel nervous, especially if you’re wondering whether you’ll be awake during the procedure. The thought of having surgery on your eye while conscious can make anyone anxious. Understanding what actually happens can help ease your worries and make the experience feel more approachable.
Most patients remain awake during ICL surgery, but that doesn’t mean you will feel pain. Your eyes are numbed with special drops, so the procedure is completely painless, and your surgeon carefully monitors your comfort throughout. In some cases, mild sedation may be offered to help you feel more relaxed. The focus is always on making the surgery smooth and stress-free for you.
Being awake during the procedure also has some advantages. It allows you to follow simple instructions, such as looking in certain directions, which helps your surgeon place the lens accurately. You may notice some movements or light, but you won’t feel discomfort or pain. Most people find the experience quicker and less intimidating than they expected.
If you want a deeper understanding of the surgery, our guide on ICL Surgery in London is very helpful. It covers the full process, who makes the ideal candidate, and the benefits of choosing an implantable collamer lens over alternatives like LASIK. Knowing what to expect beforehand can help you feel confident and calm before your consultation and surgery.
Understanding ICL Surgery
ICL surgery is a type of refractive procedure designed to correct vision problems such as myopia (short-sightedness), hyperopia (long-sightedness), and sometimes astigmatism. Unlike LASIK, which reshapes the cornea, an implantable collamer lens is placed inside the eye, between the iris and your natural lens. This means your natural lens remains untouched, which can be reassuring if you’re nervous about permanently altering the surface of your eye.
The procedure itself is usually quick and straightforward, often taking around 20–30 minutes for both eyes. Recovery is generally faster than many people expect, and patients often notice improvements in their vision almost immediately. Despite the short procedure time, it’s normal to feel apprehensive about having someone work so close to your eye while you’re awake.
Comfort and awareness during the surgery are carefully managed. Numbing eye drops are used to prevent any pain, and mild sedation may be offered for extra relaxation if needed. While you may notice light or slight movements, most patients find the experience surprisingly comfortable. Understanding what to expect can help you feel calm and prepared for your surgery.
Are You Awake During ICL Surgery?
The short answer is yes you are awake during ICL surgery. The procedure is carried out under local anaesthetic, which numbs your eye but does not put you to sleep. This allows your surgeon to communicate with you, making sure the lens is positioned accurately and that everything is going smoothly.
Being awake might sound worrying at first, but there is no need to panic. You won’t feel pain during the surgery because the anaesthetic drops block sensations in the eye. Most patients only notice pressure or gentle movement, rather than any discomfort.
Many people find the experience calmer than they expected. The surgical team explains each step as it happens, which helps you feel more relaxed and informed. Most patients report feeling surprisingly at ease throughout the procedure, and the short duration makes it even easier to stay comfortable.
Sedation Options
Staying calm during eye surgery is a common concern for many patients. While you remain conscious throughout the procedure, clinics like the London Cataract Centre provide mild sedation to ease anxiety and promote comfort. This approach is very different from general anaesthesia and is designed to help you feel relaxed without losing responsiveness. Understanding how sedation works can make the experience far less stressful.
- Mild Sedation Methods: Sedation is usually administered orally or through an IV. These methods gently calm the patient without causing full unconsciousness, allowing the procedure to proceed smoothly.
- Maintaining Responsiveness: Even with sedation, you remain awake enough to follow simple instructions. This ensures you can keep your eyes steady, which is crucial for accurate lens placement.
- Reduced Anxiety: Sedatives help lower stress and nervousness before and during surgery. Feeling calmer can improve overall comfort and cooperation throughout the procedure.
- Safety Considerations: Mild sedation carries minimal risk when administered by trained professionals. Monitoring during surgery ensures that your vital signs remain stable and that you stay alert enough to respond.
In summary, sedation offers a way to manage anxiety without compromising safety or surgical precision. By remaining conscious yet relaxed, patients can experience a smoother, more comfortable ICL procedure. Choosing mild sedation can make the surgery less intimidating while ensuring the surgeon can achieve the best results.
What You’ll See and Experience
You might be curious about what it’s like to be awake during ICL surgery. Most patients notice lights, instruments, and gentle movement around their eye, but they do not feel sharp pain. Some describe seeing shapes or flashes as the lens is carefully inserted, which is completely normal.
It’s also common for your vision to blur during the procedure. This happens because the new lens is being placed in front of your natural lens, temporarily affecting how you see. Your surgeon will guide the process carefully to ensure everything goes smoothly and safely.
You may feel slight pressure at times, particularly when your eye is held open with a speculum. However, this sensation is brief and painless, and the surgical team takes every step to keep you comfortable. Most patients are surprised at how manageable and straightforward the experience feels.
Why Being Awake Can Be Beneficial
Interestingly, being awake during ICL surgery can actually make the procedure both safer and more precise. Since you are conscious, you can follow simple instructions, such as looking in a particular direction, which helps your surgeon place the lens accurately. Your feedback also allows the surgical team to monitor your comfort throughout, ensuring the procedure goes smoothly from start to finish.
Another important benefit is that staying awake avoids the potential risks linked to general anaesthesia. You don’t need to worry about feeling nauseous, groggy, or disoriented, and there’s no extended recovery period caused by sedation. This makes the surgery less stressful and safer for patients who prefer to avoid stronger anaesthetic options.
Being awake also helps speed up your recovery. Many patients leave the clinic alert and able to resume light daily activities almost immediately. There’s no grogginess holding you back, so it’s easier to get back to your normal routine. For most people, the experience is surprisingly straightforward, and being conscious can even make the whole process feel more reassuring and controlled.
Common Concerns About Awareness
Being awake during eye surgery can understandably raise questions and anxiety. Patients often worry about pain, panic, or seeing unfamiliar instruments. Knowing what to expect ahead of time can help you feel more at ease and prepared for the procedure. Understanding these common concerns allows you to approach surgery with confidence and calm.
- Will I Feel Pain: Local anaesthetic numbs the eye completely, so you won’t experience pain. Any sensations of pressure are mild and short-lived, ensuring the procedure remains comfortable.
- Will I Panic: Most patients remain calm throughout surgery. Mild sedation and a clear explanation of each step beforehand can significantly reduce anxiety and help you stay relaxed.
- Will I See Scary Instruments: You might notice movements or lights, but these are harmless. For added comfort, some clinics recommend looking away or closing your non-surgical eye.
- How Long Will I Be Awake: Each eye typically takes 15–20 minutes, and even when both eyes are treated, the total clinic time is usually under an hour. This short duration helps make the experience manageable and stress-free.
In conclusion, concerns about being awake during surgery are common but manageable. With local anaesthetic, mild sedation, and proper guidance from your surgeon, most patients find the procedure comfortable and straightforward. Being informed about what to expect can help reduce anxiety and create a calmer, more positive experience.
How the Surgical Team Supports You
From start to finish, the surgical team prioritises your comfort and confidence. Before the procedure begins, you will receive a thorough briefing explaining what you might see, feel, and experience. Knowing what to expect helps reduce anxiety and makes the surgery feel more manageable.
During the operation, local anaesthetic drops are applied to numb your eye completely. In some cases, mild sedation may be offered to help particularly anxious patients feel relaxed. The surgical team ensures that you remain comfortable at all times, adjusting the approach to suit your needs.
Continuous communication is another key part of the process. Your surgeon may talk you through each step, offering reassurance and instructions as needed. This approach helps you feel safe, informed, and in control, even while awake during the procedure. Patients often report that this supportive environment makes the experience much easier than they anticipated.
Comparing ICL to Other Eye Surgeries
Some people hesitate to choose ICL surgery because they are worried about being awake, even though LASIK patients are also awake during their procedure. The difference lies in how the surgery is performed and what part of the eye is treated. Understanding these differences can help you make a more informed choice.
With ICL, a lens is inserted inside the eye while your natural lens remains in place. In some cases, this procedure is even reversible, offering flexibility that LASIK does not. LASIK, on the other hand, reshapes the cornea and may cause minor discomfort, but it is also performed while the patient is awake.
Both procedures are safe and effective, and being awake is standard for each. ICL has particular advantages for people with higher prescriptions or thinner corneas, making it a popular option for adults who may not be ideal LASIK candidates. Ultimately, the choice between the two depends on your individual eye health and lifestyle needs.
Recovery and Post-Surgery Awareness
After your implantable collamer lens is placed, many patients notice an improvement in their vision almost immediately. It’s normal for your sight to be slightly blurry at first, but clarity usually increases rapidly. Being awake during the surgery does not slow recovery, and most people are pleasantly surprised at how quickly they can see better.
Post-operative care is straightforward but important for the best results. Eye drops are prescribed to prevent infection and reduce inflammation, and patients are advised to avoid rubbing their eyes for a few days. Follow-up visits are scheduled to monitor healing and ensure the lens remains correctly positioned.
Interestingly, being awake during surgery can actually support your recovery. Since you are conscious, you are mentally aware of the procedure and the importance of following your post-operative instructions. This awareness often helps patients feel more confident and engaged in their healing process, contributing to smoother and safer recovery.
Tips for Staying Calm During Surgery
Feeling nervous about being awake during ICL surgery is completely normal. Many patients worry about what they will see or feel, but preparing yourself mentally can make a huge difference. Understanding the procedure, knowing what sensations to expect, and having a clear idea of how long it will take can all help reduce stress and increase your confidence on the day.
There are several practical strategies to stay relaxed before and during surgery. Asking questions beforehand ensures you know exactly what to expect at each step, while practising slow, deep breathing can help calm your body and mind. Some patients also find visualisation techniques or listening to calming music before the procedure useful to maintain a relaxed state.
Additional support measures can make the experience even easier. Mild sedation is available for those who feel particularly anxious, and bringing a trusted friend or family member can provide reassurance before and after the surgery. Many patients report that combining mental preparation with these comfort strategies not only reduces anxiety but also makes them feel more in control and confident throughout the process.
Who Might Need Additional Support
Some patients experience higher levels of anxiety or have a history of panic attacks, which can make being awake during ICL surgery feel overwhelming. For these individuals, additional support measures can help ensure the procedure is as comfortable and stress-free as possible. Understanding that these options are available can also reduce pre-surgery worry and help patients feel more in control.
In certain cases, the surgical team may offer a higher level of sedation to help patients remain relaxed throughout the procedure. Although it is rare, general anaesthesia can be considered if it is medically appropriate and requested. The choice of support is personalised for each patient, ensuring that their needs and comfort are fully addressed without compromising safety.
Your comfort and safety are always the top priorities during ICL surgery. The surgical team will discuss all available options in advance, answering any questions and addressing any concerns you may have. Knowing that extra support is available, if needed, can provide reassurance and confidence, allowing you to approach your surgery calmly and positively.
My Personal Take on Being Awake During ICL Surgery
Having spoken with dozens of patients over the years, I can confidently say that being awake during ICL surgery is rarely an issue. Many people are pleasantly surprised at how calm they feel once the anaesthetic takes effect. Being prepared and understanding each step of the procedure beforehand can make a huge difference, helping to ease anxiety and build confidence before the surgery begins.
The sensations experienced during the procedure are mild and very temporary. Patients may feel slight pressure or notice brief flashes of light as the lens is inserted, but these are completely harmless and do not cause pain. The surgical team is there at every moment to reassure you, answer questions, and make any adjustments needed, ensuring the experience feels smooth, controlled, and safe.
From my perspective, the overall process is much easier and less stressful than most people imagine. Being awake allows you to actively participate in your care, follow instructions, and feel in control throughout. Most patients leave the clinic amazed at how straightforward and comfortable the surgery was, often noting that their initial worries were far greater than the reality.
Preparing Mentally for Your Surgery
One of the most important aspects of preparing for ICL surgery is mental readiness. Knowing in advance that you will be awake allows you to plan strategies to stay relaxed, ask any questions you may have, and discuss sedation options with your surgeon. Feeling prepared mentally can make a big difference to how comfortable and confident you feel on the day of your procedure.
I often recommend that patients visualise each step of the surgery beforehand. Mentally rehearsing what will happen from sitting in the chair to the lens being inserted can help reduce uncertainty and ease nerves. This practice makes the process feel familiar, which often translates into a calmer and more relaxed experience during the actual procedure.
Practising relaxation techniques can also be very helpful. Slow, deep breathing, mindfulness exercises, or even listening to calming music before surgery can keep your body and mind at ease. Combining mental preparation with these simple strategies can give patients a sense of control and reassurance, making the overall experience far smoother than they might expect.
The Role of Technology in Patient Comfort
Modern ICL procedures are supported by advanced technology, including high-precision lasers, specialised instruments, and real-time imaging. These tools allow the surgeon to work with exceptional accuracy, reducing the duration of the procedure and minimising any potential stress for the patient. The result is a faster, smoother surgery that feels far less daunting than many people anticipate.
Because the procedure is so streamlined, being awake is much less intimidating than it might initially seem. Patients often report that seeing the technology in action knowing that it guides every step provides reassurance and confidence. The careful combination of expert skill and cutting-edge equipment ensures that each movement is precise and controlled.
Technology also plays a key role in patient safety and comfort. Real-time imaging and specialised instruments allow the surgical team to monitor your eye continuously, reducing the risk of complications and making adjustments as needed. Even while conscious, you can feel confident that every aspect of the procedure is carefully managed, giving peace of mind throughout the surgery.
Why Patients Often Feel Surprised by the Experience
Many patients are initially worried about being awake during ICL surgery, but most report that the reality is far less daunting than they imagined. The procedure is generally quiet, quick, and surprisingly painless, which often comes as a relief to first-time patients. Understanding this beforehand can ease anxiety and help patients approach the surgery with confidence.
Knowing what to expect plays a huge role in reducing stress. Being aware of the sensations you might feel, such as slight pressure or brief flashes of light, helps patients feel prepared rather than caught off guard. Most people find that these experiences are minor and temporary, with no lasting discomfort.
The option of mild sedation also contributes to a more relaxed experience. Patients who are particularly anxious can take comfort in knowing that the surgical team is ready to provide extra support if needed. As a result, many leave the clinic feeling surprised at how calm, comfortable, and straightforward the procedure was compared with their initial expectations.
Aftercare Tips to Maximise Comfort
Being awake during surgery doesn’t end the need for careful post-operative care. Proper aftercare helps reduce discomfort, supports healing, and ensures the best possible results. Simple routines and precautions can make a big difference in how smoothly your recovery progresses. Understanding these steps ahead of time helps patients feel more in control after their procedure.
- Use Prescribed Eye Drops on Schedule: Eye drops reduce inflammation, prevent infection, and promote healing. Following the schedule carefully ensures your eyes recover quickly and comfortably.
- Avoid Strenuous Activity: For a few days after surgery, it’s important to rest and avoid heavy lifting or vigorous exercise. This minimizes strain on your eyes and supports proper healing.
- Attend Follow-Up Appointments: Regular check-ups allow your surgeon to monitor progress and address any concerns early. This ensures your recovery stays on track and any issues are managed promptly.
- Wear Sunglasses for Protection: Sunglasses shield your eyes from bright light, UV rays, and dust. Protecting your eyes helps reduce irritation and keeps you comfortable while they heal.
In summary, following simple aftercare tips is key to a smooth recovery. By using your eye drops correctly, resting appropriately, keeping appointments, and protecting your eyes, you can minimise discomfort and support the healing process. These steps help ensure that the benefits of your surgery are maximised and long-lasting.
Choosing the Right Clinic
Selecting a clinic with extensive experience in ICL surgery is essential for both a successful procedure and a comfortable experience. A well-established centre will have systems in place to ensure patient safety, comfort, and confidence throughout the process. This is particularly important for patients who may feel anxious about being awake during the surgery.
When evaluating clinics, look for those that prioritise patient-focused care. This includes clear explanations of the procedure, sedation options, and what to expect before, during, and after surgery. Being informed ahead of time can significantly reduce stress and help you feel more prepared on the day.
It’s also important to choose a clinic with highly experienced surgeons who have a proven track record of excellent outcomes. Expertise ensures that every step of the procedure is handled efficiently and safely, allowing patients to remain calm and reassured. When the clinic emphasises both skill and comfort, being awake during surgery becomes a positive, manageable experience rather than a source of anxiety.
FAQs:
1. Am I awake during ICL surgery?
Yes, most patients remain awake during the procedure, which is performed under local anaesthetic. You won’t feel pain, only mild pressure or movement.
2. Does being awake during ICL surgery hurt?
No, numbing eye drops prevent pain. Some patients notice slight pressure or movement, but these sensations are brief and painless.
3. Is sedation available during ICL surgery?
Yes, mild sedation can be offered to help anxious patients feel relaxed, while still allowing them to follow instructions during the surgery.
4. What will I see during the surgery?
You may notice lights, shapes, or flashes as the lens is inserted, and your vision may blur temporarily, which is normal and harmless.
5. How long does ICL surgery take?
Each eye typically takes 15–20 minutes, and even when both eyes are treated, the total time at the clinic is usually under an hour.
6. Why is it beneficial to be awake during ICL surgery?
Being awake allows you to follow instructions, helps the surgeon position the lens accurately, avoids general anaesthesia risks, and supports faster recovery.
7. Can I panic or feel anxious during the procedure?
Most patients remain calm, especially with proper preparation, explanations from the surgical team, and optional mild sedation if needed.
8. How should I prepare mentally for surgery?
Visualise the procedure, practice relaxation techniques like deep breathing, ask questions beforehand, and consider listening to calming music.
9.What is recovery like after ICL surgery?
Recovery is usually quick, with immediate improvements in vision. Using prescribed eye drops, avoiding strenuous activity, and attending follow-ups are key to smooth healing.
10. How do I choose the right clinic for ICL surgery?
Look for experienced surgeons, patient-focused care, clear explanations, and clinics that offer sedation options to ensure a comfortable, safe experience.
Final Thoughts: Staying Calm and Informed During ICL Surgery
Being awake during ICL surgery is a common concern, but understanding the procedure, knowing what sensations to expect, and having options like mild sedation can make the experience surprisingly comfortable and manageable. Preparation, clear communication with your surgical team, and following post-operative care instructions all contribute to a smoother recovery and a more positive surgical experience.
If you’re considering ICL surgery in London, you can get in touch with us at London Cataract Centre to discuss your options, address any concerns, and ensure a personalised approach to your comfort and vision care.
References:
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- Ando W., Kamiya K., Hayakawa H., Takahashi M. & Shoji N. (2020) Comparison of Phakic Intraocular Lens Vault Using Conventional Nomogram and Prediction Formulas. Journal of Clinical Medicine, 9(12). Available at: https://www.mdpi.com/2077-0383/9/12/4090
- Abdelhakim S.M.N. (2025) Comparison of White-to-White Measurement by IOL Master and Caliper and Sulcus Measurement for Phakic PC ICL by UBM. QJM: An International Journal of Medicine Available at: https://academic.oup.com/qjmed/article-abstract/118/Supplement_1/hcaf224.176/8341185
- Gong D., Deng S., Dang K., Yan Z. & Wang J. (2024) Causes and Management Strategies for Elevated Intraocular Pressure After Implantable Collamer Lens Implantation. Frontiers in Medicine. Available at: https://pubmed.ncbi.nlm.nih.gov/38384405/
- Alfonso, J.F., Lisa, C., Fernández‑Vega, L., et al. (2014) Long‑term refractive outcomes of posterior chamber phakic (spheric and toric implantable collamer lens) intraocular lens implantation. Clinical Ophthalmology, 8, pp. 1973–1982. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC4028544/