Aim: To compare the efficacy of two different doses of dexamethasone as an adjuvant to local anaesthetic on onset and duration of lid and globe akinesia, and postoperative analgesic requirement following cataract surgery in a tertiary eye hospital performing high volume blindness preventive surgeries. Method: An observational study was conducted among 120 patients of 40 – 85 years age, posted for small incision cataract surgery (SICS) under peribulbar block. Patients were allotted to three equal groups – LAO: Local Anesthetic only, LAD2: Local Anesthetic with dexamethasone 2 mg, and LAD4: Local Anesthetic with dexamethasone 4 mg. Onset and duration of lid and globe akinesia and postoperative analgesic requirement between the groups were compared. Result: Median difference of lid and globe akinesia onset, globe akinesia duration and difference in proportion of postoperative analgesic request was statistically significant in group LAD4 (p value<0.001). Difference in median visual analogous score (VAS) at 2, 6 and 8 hours and postoperative analgesic requirement was statistically significant (p value<0.05) in LAD4 group when compared to LAD2 and LAO group. Conclusion: Dexamethasone as an adjuvant to local anesthetic accelerates the onset of lid and globe akinesia, prolongs the duration of globe akinesia and reduces postoperative analgesic requirements thereby reducing morbidity. Dexamethasone 4 mg is more effective as compared to 2 mg.