Almost every modern anaesthetic has an impact on the complex physiology of the intraocular pressure. The different factors influencing the intraocular pressure are discussed. With the exception of succinylcholine and ketamine all other substances used in modern anaesthesia produce a more or less significant reduction of the intraocular pressure. Hence, the anaesthesiologist disposes in general of a great variety of drugs to conduct an anaesthesia that is well adapted to the physiological requirements of the eye. Yet, he may still encounter some difficulties in emergency-situations, like a perforating eye trauma in a patient with a full stomach. Fazadinium may be a usefull alternative to succinylcholine in these situations, as its rapid onset of action is not accompanied by a rise in the intraocular pressure. Some other measures to reduce the intraocular pressure intraoperatively are also mentioned, like controlled hypotension, osmotic diuresis and inhibition of the carbonic anhydrase.