Many patients are on anti-coagulant medications. These medications are prescribed by their generalist or cardiologist for various medical conditions. The anti-coagulation status of any patient under going eye surgery needs careful consideration. Phacoemulsification, trabeculectomy, corneal transplantation and vitrectomy all require a degree of hemostasis. The decision to stop the anti-coagulation medication prior to surgery needs communication between the patient, surgeon and physician to decide the safest course of action. It is balance between the risks of significant bleeding during the surgery potentially resulting in poor visual outcome vs the risk of systemic blood clot such as DVT, pulmonary embolus and stroke. The newer class of anti-coagulants, the NOAC's is specifically addressed.