Turn up the Lights During Colonoscopy

Turn up the Lights During Colonoscopy

Douglas K. Rex, MD, MASGE, reviewing Hoff RT, et al. Endosc Int Open 2021 May 27.

Traditionally, room lights are turned down quite low during endoscopy. In a single-center retrospective study, 498 colonoscopies were performed by 9 gastroenterologists in low light (<75 lux) and 611 using ambient light (75-150 lux). The colonoscopies performed with low room lighting could be considered the historical controls. 

From low lighting to more ambient lighting, the adenoma detection rate (ADR) increased from 34.5% to 36%, a nonsignificant change. However, in comparing the ADRs from cases performed from the beginning of the day to the end of the day, the ADR dropped 5.6% during the low-light period but increased 2.8% with ambient light. The ADR changes through the day were significantly different, suggesting that increased ambient lighting produces less eye fatigue. Ambient lighting resulted in lower eyestrain scores (8.12 vs 5.63), as rated by the endoscopists. Most of the endoscopists also thought it was easier to detect changes in patients’ clinical status with increased ambient lighting.

Douglas K. Rex, MD, FASGE


These data are not well controlled, but they suggest that there is no downside for adenoma detection with ambient lighting and that brighter lighting decreased eyestrain.

Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.


Hoff RT, Mazulis A, Doniparthi M, et al. Use of ambient lighting during colonoscopy and its effect on adenoma detection rate and eye fatigue: results of a pilot study. Endosc Int Open 2021;9:E836-E842. (https://doi.org/10.1055/a-1386-3879)

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