Purpose: To evaluate pain and discomfort experienced by patients who have uncomplicated cataract extraction using topical anesthesia with no intravenous sedation. Setting: Fichman Eye Center, Manchester, Connecticut. Methods: Blood pressure, heart rate, and respiration were measured preoperatively, during cataract surgery, and postoperatively in 100 randomly selected patients. The average of these measurements (procedural vital) was compared with the blood pressure, heart rate, and respiration levels during surgery. Results: On average, patients had a negligible increase in blood pressure (1 %), a small decrease in heart rate (2%), and a slight decrease in respiration (1 %). Conclusion: Because the vital signs were essentially unchanged during surgery, I believe patients were very comfortable despite having no intravenous sedation.