Injections of local anesthetic behind the globe could potentially damage the optic nerve, resulting in visual field defects or even blindness. Glaucoma patients may be at increased risk of this occurring, because of increased susceptibility to pressure/ischemic damage. In extreme cases, this may manifest as visual field “wipe-out.” Because of these concerns, “newer” techniques of anterior placement of anesthetic have been promoted, including subconjunctival, anterior sub-Tenon’s, topical, and intracameral anesthesia. There remains some controversy regarding the effect of different anesthesia techniques on complication and failure rates for glaucoma surgery.