To outline recent developments emphasizing the current literature on ophthalmic regional anaesthesia including modern sharp needle and blunt cannula sub-Tenon's blocks.Local anaesthesia is commonly used for ophthalmic surgery but the techniques and choice vary. Akinetic ophthalmic regional blocks such as intraconal and extraconal blocks with needles are generally safe, but although rare, serious sight and life-threatening complications continue to occur. Newer akinetic sub-Tenon's block with a blunt cannula has emerged as a safer alternative to needle blocks, but although unusual, both sight and life-threatening complications have been reported.At present, there is no absolutely safe ophthalmic regional block. It is imperative therefore to have a basic knowledge of anatomy and technique which reduce complications.