Oral sucrose reduces pain during heel sticks and venipunctures in preterm infants, but no studies have been done to determine the effectiveness of sucrose during eye examinations for retinopathy of prematurity. Therefore, the purpose of this study was to determine the effectiveness of local anesthetic eye drops and a pacifier, plus repeated doses of 24% sucrose, to relieve pain associated with eye examinations for retinopathy of prematurity. In this double-blind randomized controlled trial, 30 preterm infants were randomly assigned to one of two treatments, in which they received either local anesthetic eye drops, a pacifier, plus three doses of sterile water or local anesthetic eye drops, a pacifier, plus three doses of 24% sucrose during the eye examination. Treatment effectiveness was determined using a validated infant pain measure, the Premature Infant Pain Profile (PIPP), which includes measures of facial expressions, heart rate, and oxygen saturation and takes behavioral state and gestational age into consideration. Data were collected before, during, and following an examination of the left eye. Statistically significant differences in mean PIPP scores were found between the sucrose and water groups during the left eye examination. The mean PIPP score was 8.8 for the sucrose group and 11.4 for the water group ( t = 2.87, p = .008 two-tailed). No significant differences were found in PIPP scores immediately following the procedure. Sucrose and a pacifier may be beneficial for minimizing pain during eye examinations in preterm infants and should be considered as a part of evidence-based guidelines for relieving pain during this procedure.