Anesthesia in ophthalmic surgery has a unique set of challenges since it applies to patients in the extremes of age; either those who are extremely young or old. Each age group that is subjected to ophthalmic surgery has its own unique set of problems and necessities. This paper reviews the preoperative preparations of the patient, the selection of the proper technique, the most suitable technique for different patients, and the complications that can take place and how to safeguard against them. Contents of this paper are based on my personal point of view based on years of experience in the field, and backed by international literature on the topic