Achieving the State of Flow in Cataract Surgery

The psychological state of Flow is described as “energized focus, full involvement, and enjoyment” of the action being performed. Some call this being “in the zone” during surgery so that seemingly challenging cases become relatively easy and things just seem to work out well. There are no wasted movements during surgery and the procedure becomes very efficient. The entire surgery is simply a pleasure and it gives us immense satisfaction (and gives patients great vision). This is what we strive for in our surgical careers.

Psychologists have six factors which encompass the feeling of flow:

  • 1. intense focus and concentration during surgery
  • 2. merging of action and awareness seamlessly
  • 3. loss of self-consciousness; focus is on the surgery and the patient
  • 4. a sense of being in control during surgery
  • 5. altered sense of time; focused on the surgery, not on the clock
  • 6. feeling that the surgery is rewarding to the surgeon (and to the patient)

The father of this concept of Flow is Mihaly Csikszentmihalyi who notes that while in the state of flow, people report that it is like a water current carrying them along, hence the name. He also notes that for the Flow Experience, three additional factors exist:

  • 1. immediate feedback, which we certainly get during surgery
  • 2. feeling that the potential to succeed exists
  • 3. feeling completely engrossed and encompassed by the experience

Ocular surgery, particularly cataract surgery, puts me in the state of flow. It is an immense pleasure and something that I look forward to every day. We are so very fortunate to be ophthalmologists where we can derive such enjoyment and an amazing experience from a procedure that brings an equal level of joy and satisfaction to our patients.

Click below to see a video of a case that reflects my feeling of the Flow Experience:


  1. Wonderful post. I read Csikszentmihalyi’s ideas a few years ago and thought at the time how nicely those ideas apply to cataract surgery – the focus needed, the feeling of accomplishment, the complexity involved and the ever present need to challenge oneself to always do better. Add to that the immense gratitude we get from our patients — plus we actually get paid to do this! For me, flow leads to happiness. Awesome post. Uday, keep up this great work!

    1. thank you for the kind feedback — I agree completely, we are so blessed to be ophthalmologists. I am thankful every day.

  2. Hi how and when did you achieve that flow state? I’m currently a trainee in ophthalmology and have already started cataract surgery. we operate roughly once a week. Still feel so anxious everytime I do a surgery… wish to enter that flow rate…

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