A prospective randomised study is reported comparing a single peribulbar injection into the medial compartment of the orbit and the standard two injection peribulbar technique. One hundred and seven patients undergoing elective intra-ocular surgery were randomly allocated to receive either a single medial injection, or two injections, using prilocaine 3% with felypressin. Akinesia and pain during surgery were assessed following the injection(s). There was no significant difference in pain during surgery and globe akinesia between the two groups. The single medial peribulbar injection is as effective as two injections using prilocaine 3%.