OBJECTIVE To summarize recent knowledge concerning ophthalmic regional anaesthesia. RESULTS Ophthalmic regional anaesthesia has changed considerably over the past few years. Alternatives to retrobulbar anaesthesia have been proposed to reduce the number of complications without detriment to efficiency. Finally new local anaesthetics have been adopted and the indications have broadened, especially in vitroretineal surgery. CONCLUSIONS New developments in ophthalmic regional anaesthesia are presented in this review. Different methods, indications and side effects are described in order to facilitate the clinician's choice, without any claim to single out an ideal technique.